Spine · Non-operative care

Thoracic Compression Fracture

Most spine pain never needs surgery. OSI evaluates you, orders imaging only when it will actually change the plan, and walks you through the non-operative care that handles the vast majority of spine problems — activity guidance, physical therapy, medications, and targeted injections.

Overview

what it is and why it matters
Labeled diagram of the vertebral column: cervical, thoracic, lumbar, sacral, and coccygeal segments with intervertebral discs.
Spine anatomy. The spinal column has 33 vertebrae grouped into the neck (cervical), upper back (thoracic), lower back (lumbar), sacrum, and tailbone. Soft intervertebral discs sit between each pair of vertebrae as cushions; the spinal cord and its nerve roots run through the hollow canal at the back.
OpenStax Anatomy & Physiology · Public Domain

Thoracic compression fractures are the most common vertebral fractures, occurring when a vertebral body collapses under compressive load. In older patients with osteoporosis they can occur from minimal trauma — even coughing or bending. In younger patients they require significant force (fall from height, high-energy sports impact). T12 and L1 are the most commonly fractured vertebrae (the thoracolumbar junction).

The classic symptom is sudden onset midline back pain at the fracture level, often without neurologic symptoms. Multiple fractures can cause progressive kyphotic deformity.

Diagnosis

exam first, imaging second

Plain X-rays confirm the fracture and assess degree of height loss and kyphotic angulation. MRI distinguishes acute from chronic fractures (bone marrow edema on STIR sequences), identifies posterior ligamentous complex injury, and assesses for retropulsion into the canal. CT defines bony detail for surgical planning. DEXA scan to assess bone density is essential in osteoporotic fractures.

Treatment Path

how care progresses at OSI
1

Pain management

NSAIDs, acetaminophen, and short-term opioids for acute fractures.

2

Thoracolumbosacral orthosis (TLSO brace)

Extension bracing for 6–12 weeks in stable fractures.

3

Osteoporosis treatment

Anti-resorptive or anabolic therapy (bisphosphonates, teriparatide) to prevent future fractures is essential.

  1. Physical therapy

    Extension strengthening and posture correction once acute pain resolves.

If Surgery Is Truly Needed

rare for most patients

Surgery helps only a small minority of spine patients — usually those with a specific structural problem plus a nerve issue that isn’t getting better with a structured non-operative trial. When that step is genuinely warranted, OSI coordinates it the same way we coordinate every other part of your care: imaging, records, and the handoff are handled for you, so no part of the process falls on your shoulders.

Emergency. New leg weakness, numbness below the level of injury, or loss of bladder or bowel control after a spinal fracture requires emergency evaluation. Go to the nearest emergency department.

Further Reading

authoritative sources

External patient-education references and related OSI pages for additional background:

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