Vertebral Compression Fracture (Spine)

Description

A vertebral compression fracture is a “squeeze” injury to one of the bones of the spine (a vertebra), in which the front of the bone is compressed into a slightly wedged shape. In children these are usually stable and heal well.

How it happens (the mechanism)

A downward (axial) load on the spine — a fall onto the bottom or back, or landing hard from a height — squeezes the front of a vertebra and compresses it into a wedge, while the back wall of the bone and the ligaments usually stay intact, which is what makes most of these stable. A child’s spine also remodels, so mild wedging tends to improve with growth.

One thing the doctor weighs is the size of the force versus the injury: if a vertebra compresses from only minor trauma, it is worth making sure the bone itself is healthy, since weakened bone can break more easily.

Symptoms

Back pain at the level of the injury, worse with movement, sometimes with muscle spasm. Most children can still move their legs normally.

Doctor examination and imaging

The doctor examines the back and checks the strength, feeling, and reflexes of the legs. X-rays show the wedged vertebra; an MRI or CT is sometimes added to judge how recent or how stable the fracture is, or to look at the soft tissues.

Treatment

Most stable compression fractures are treated without surgery — a short period of rest, pain control, and activity as comfort allows, sometimes with a brace for support. Follow-up X-rays confirm healing and remodeling. Surgery is reserved for the uncommon unstable injury or one affecting the nerves.

Recovery and long-term outlook

Most children recover well, and mild wedging often remodels with growth. The spine is followed until healing is confirmed.

When to call the doctor

Seek care right away for weakness, numbness, or tingling in the legs, trouble walking, or any loss of bladder or bowel control — these need urgent evaluation. Also call for severe or worsening back pain, fever, or pain that wakes your child at night.

Learn more

OrthoInfo (AAOS) — Growth Plate Fractures: orthoinfo.aaos.org

This information is for educational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. For specific concerns about your child, consult a board-certified, fellowship-trained pediatric orthopaedic surgeon.