Why are older adults prone to vertebral compression fractures?

  Osteoporosis is a systemic disease characterized by reduced bone mass and degradation of bone microstructure, leading to increased bone fragility and susceptibility to fracture, most commonly in postmenopausal women and the elderly population. Due to a significant reduction in the biomechanical properties of the vertebral body, osteoporotic patients are prone to compression fractures when subjected to minor external forces. Only 25% of patients with osteoporotic compression fractures have a clear history of trauma and a 20% or 4 mm reduction in vertebral body height is considered a compression fracture. There are three types of osteoporotic compression fractures: wedge compression fractures, biconcave compression fractures and comminuted compression fractures, of which The most common type is the wedge compression fracture (51%). Only 23-33% of compression fracture patients present with clinical symptoms, mainly pain, progressive crestal collapse, and kyphotic deformity, which severely affects patients’ quality of life, physical activity, mental health, and longevity. Traditional treatment is long-term bed rest + drug non-surgical treatment, but long-term bed rest is likely to aggravate the degree of osteoporosis and cause complications; surgical treatment is prone to surgical complications due to poor repositioning and fixation of osteoporosis, long recovery time, and a 5-25-fold increase in the risk of recurrence of compression fracture within one year in the adjacent vertebrae of patients with compression fracture. Currently, percutaneous vertebroplasty (PVP) or percutaneous kyphoplasty (PKP) is considered to be a better treatment for osteoporotic vertebral compression fractures without neurological symptoms, which can be performed by fluoroscopically guided injection of bone cement into the diseased vertebral body and achieve pain relief.