Just lifting a batch of cabbage for kimchi-making led to a sharp twist in the back, but the diagnosis at the hospital was a "spinal fracture." For the elderly with weakened bones, this is not an unusual occurrence. When osteoporosis is severe, even without a fall, simply lifting heavy objects or bending the back can cause the vertebrae to collapse.

A spinal compression fracture occurs when the vertebrae fail to withstand external pressure and flatten downward. Among older adults, osteoporosis is the primary cause. Osteoporosis is a condition where bone density decreases and bone microarchitecture weakens, making bones prone to breaking under minor impacts. Because it usually presents no symptoms in daily life, it often progresses unnoticed.

"The Vicious Cycle of Fractures": Breaking Once Leads to Another

The real trouble begins after the fracture. When compressed vertebrae cause the spine to hunch or misalign, the body's center of gravity shifts forward, leading to an unsteady gait. This increases the risk of falling again, triggering a vicious cycle of subsequent fractures. Patients who have suffered osteoporotic spinal compression fractures face a high risk of additional fractures and require consistent, long-term management.

Dr. Park Jung-hyun, a neurosurgery specialist at the Spine Center of Juan Nanuri Hospital, noted, "Spinal compression fractures in the elderly should not be viewed merely as simple fall accidents, but must be examined alongside osteoporosis, which weakens the bones." He added, "If back or spine pain persists after a fall or if mobility becomes difficult, individuals should check for spinal fractures and undergo comprehensive osteoporosis screening."

Diagnosis begins with a spinal X-ray to check for bone deformation and fractures. When necessary, an MRI provides a detailed look at acute fractures and surrounding nerve compression. A bone mineral density (BMD) test is also performed to assess the severity of osteoporosis and evaluate the risk of future fractures.

Beyond Cement Surgery: Osteoporosis Treatment is the "Real Treatment"

Treatment is determined based on the severity of the fracture, pain levels, spinal stability, and the patient's overall health condition. If the fracture is relatively stable and there are no neurological abnormalities, conservative treatments—such as pain relievers, brace wearing, and activity modification—are prioritized. During this period, prolonged bed rest can lead to muscle loss and complications, making it crucial to resume movement at the appropriate time under medical guidance.

When severe pain persists despite sufficient conservative treatment or severely limits daily activities, a percutaneous vertebroplasty may be considered. This procedure stabilizes the fractured site by injecting medical bone cement into the fractured vertebra using a fine needle. While it provides pain relief, it is not necessary for every compression fracture patient and must be carefully decided based on imaging exams and symptoms.

Even more important is post-fracture management. Spinal vertebroplasty stabilizes the fractured area, but it does not cure osteoporosis itself. If bones remain weak, new fractures can occur in other vertebrae or the hips. Comprehensive care—including osteoporosis medication, regular bone density tests, strength and balance exercises, and environmental modifications to prevent falls—must be implemented simultaneously.

Dr. Park emphasized, "The goal of spinal compression fracture treatment goes beyond immediate pain relief; it is to help patients safely walk and maintain their daily lives again. Because the risk of additional fractures increases significantly after a single fracture, persistently treating and managing osteoporosis is of utmost importance."

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