# How to Diagnose and Manage Vertebral Compression Fractures in the ED

About This Podcast

In this episode, Dr. Shenvi is joined by Dr. Dachs for a conversation about vertebral compression fractures. Dr. Dachs worked in rural EDs for over 3 decades and is now the Assistant Director of the Dept. of Emergency Medicine at Ellis Hospital in upstate New York.

Learn about who is at risk of getting a vertebral compression fracture, how they present, what evaluation is needed, and how to prevent a future fracture.

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https://youtu.be/oYs0WRbs-no

Key Points

Vertebral compression fractures are the most common type of fragility fracture and about 2/3 of them are asymptomatic

They can occur with minor trauma, especially in women and those with or those at risk of osteoporosis or osteopenia

The most common locations are T10 to L2

There are several early and late associated complications that ED clinicians need to be able to address

It is important to look for any signs that the injury may be more than just a vertebral compression fracture

Pain management:

Appropriate analgesics plus nasal calcitonin

Evidence for bracing is inconclusive

Referral to physiotherapy to develop strength and prevent future falls

Prevent future fractures:

Start Ca++ intake 1000-1200mg a day

Start Vitamin D 600 – 800mg a day

Start bisphosphonates

Next, listen to Do Anticoagulants Matter After a Head Injury? with Dr. Kerstin de Wit.

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