What is the recommended initial management for vertebral compression fractures?

What is the recommended initial management for vertebral compression fractures?

• A. Early mobilization with conservative treatment
• B. Immediate vertebroplasty
• C. Open decompression
• D. Prolonged bed rest

Answer: (B)

Vertebral compression fractures are most often managed first with nonoperative care that focuses on pain control and preserving function. Start with effective analgesia tailored to the level of pain, such as acetaminophen and NSAIDs, with a short course of opioids if breakthrough pain is needed. Prolonged bed rest should be avoided because it leads to deconditioning and other complications. Encourage gradual mobilization as tolerated and consider a back brace to help stabilize the fracture and reduce movement-related pain. Addressing underlying bone health with osteoporosis treatment is also important to prevent future fractures. Invasive procedures like vertebroplasty or kyphoplasty, or open decompression, are not initial steps. They’re generally reserved for cases where pain persists despite adequate conservative management or when there are neurologic deficits or instability that require surgical intervention.

Vertebral compression fractures are most often managed first with nonoperative care that focuses on pain control and preserving function. Start with effective analgesia tailored to the level of pain, such as acetaminophen and NSAIDs, with a short course of opioids if breakthrough pain is needed. Prolonged bed rest should be avoided because it leads to deconditioning and other complications. Encourage gradual mobilization as tolerated and consider a back brace to help stabilize the fracture and reduce movement-related pain. Addressing underlying bone health with osteoporosis treatment is also important to prevent future fractures.

Invasive procedures like vertebroplasty or kyphoplasty, or open decompression, are not initial steps. They’re generally reserved for cases where pain persists despite adequate conservative management or when there are neurologic deficits or instability that require surgical intervention.