By Mr Ahmed-Ramadan Sadek, Neurosurgeon · Last reviewed October 2026 · 6 min read

What is a vertebral compression fracture?

Each bone of the spine (a vertebra) has a solid, roughly box-shaped front section called the vertebral body, which carries most of your weight. If this bone is weakened, it can give way and squash down. The front edge usually collapses more than the back, leaving the bone wedge-shaped. This is called a compression or wedge fracture, and the change in shape is permanent.

What causes it?

• Osteoporosis, a condition in which bones lose density and strength. A fracture may follow a minor fall, lifting, or even a cough or sneeze, and some people cannot recall any injury at all.
• Injury, such as a significant fall or accident, which can fracture even healthy bone.
• Cancer that has spread to the spine, or that starts in the bone marrow, which can weaken the vertebra from within. This is a less common cause.
• Long-term steroid treatment or certain metabolic conditions, which can lead to osteoporosis.

Symptoms

A new fracture often causes sudden, severe pain in the middle or lower back, typically worse on standing, walking or turning and eased by lying down. Over time, especially if several bones are affected, people may lose height and develop a rounded, stooped upper back (a kyphosis).

In some cases the bone continues to collapse and narrows the space for the spinal nerves. This can cause pain, tingling, numbness or weakness in the areas those nerves supply. Some ongoing pain may also come from muscle spasm or from strain on the small joints of the spine as people lean back to compensate for the stoop.

How is it diagnosed?

X-rays show the shape of the vertebrae. An MRI scan helps tell whether a fracture is recent and still healing, which matters when deciding on cement treatment, and can help identify any underlying cause. A bone density scan may be arranged to check for osteoporosis, and blood tests may be needed if another cause is suspected.

Treatment without surgery

Most compression fractures are treated conservatively while the bone heals naturally. This usually involves:

• Pain relief, adjusted to allow you to move about
• A short period of reduced activity or rest, followed by a gradual return to walking
• Sometimes a supportive brace
• Physiotherapy to maintain strength and posture
• Treatment for osteoporosis to strengthen the bones and reduce the chance of further fractures

Who might be offered vertebroplasty or kyphoplasty?

Cement treatment may be considered when conservative care is not working or is difficult to tolerate. the British Association of Spine Surgeons (BASS) patient information lists situations including:

• Pain that remains uncontrolled despite appropriate treatment
• Health conditions that make bed rest or strong painkillers unsuitable
• Older or frail patients whose bones are likely to heal poorly
• Fractures caused by a cancerous tumour in the bone
• Osteoporosis resulting from long-term steroid use or a metabolic disorder

It is worth knowing what the procedure cannot do. Cement steadies the broken bone, but it does not reverse a stoop or treat pain arising from muscles or other spinal joints.

What happens during the procedure?

The procedure is normally done under general anaesthetic, with you lying face down. After the skin is cleaned, the surgeon makes a tiny cut on one or both sides of the spine for each bone to be treated.

Using continuous X-ray pictures as a guide, a hollow needle is steered through the back muscles into a narrow channel of bone called the pedicle, and on into the fractured vertebral body. Its position is checked from several angles.

Vertebroplasty

Liquid bone cement is injected directly through the needle into the broken bone. X-rays are taken to watch where the cement goes. It sets hard within minutes, bracing the fracture from the inside.

Kyphoplasty

A small balloon is first passed through the needle and inflated inside the vertebra to create a cavity. The balloon is then removed, and cement is injected into the space it has made, again under X-ray monitoring.

Before your procedure

Let your team know about all your medicines. Blood thinners such as warfarin, aspirin, rivaroxaban or clopidogrel usually need to be stopped beforehand, so check promptly if your date is arranged at short notice. Also mention diabetes, any immune problems or steroid use, as these can increase infection risk.

Risks and complications

Serious problems are uncommon, but you should be aware of them. Where figures are given, they come from BASS patient information.

Risk	Approximate frequency (BASS)
Superficial wound infection	2 to 4 in 100
Deep wound infection	Fewer than 1 in 100
Death from major blood vessel or organ injury	About 1 in 10,000
Fatal general anaesthetic complication	About 1 in 250,000

BASS also describes the following risks without giving figures:

• Cement leakage outside the bone. Heat or pressure in the spinal canal could injure nerves and, in extreme cases, cause paralysis. X-ray monitoring allows the surgeon to stop injecting at the first sign of leakage.
• Embolism, where tiny particles of cement, fat, air or tumour enter the bloodstream and lodge elsewhere, which in severe cases can strain the lungs or heart.
• Reaction to the cement, which can disturb the heart rhythm and, extremely rarely, cause cardiac arrest.
• Fracture of a neighbouring vertebra in future, possibly more likely because the treated bone is now stiffer.
• Bleeding, and pressure or eye problems related to lying face down.

After the procedure and recovery

You will wake in the recovery area and, once comfortable, can usually get up, sometimes the same day. Many people notice their fracture pain easing fairly quickly. If no further treatment is needed, most go home the next day once a physiotherapist is happy with their walking.

• Arrange for someone to collect you; BASS advises against driving or using public transport for 48 hours after the anaesthetic.
• Expect to be off work for at least 48 hours, or longer if discomfort continues.
• Keep the small wounds clean and dry, and contact your GP or hospital if they become red, leak or you develop a temperature.

• BASS patient booklet: Vertebral Compression Fracture: Vertebroplasty and Kyphoplasty
• NHS: Osteoporosis
• Royal Osteoporosis Society

This guide is general information and is not a substitute for advice about your own situation. Please speak to your GP or specialist.