What to expect after a significant L1 compression fracture?

54 years of age is quite young. What happened 6 months ago to cause your fracture? Do u have osteoporosis?

Most compression fractures heal without surgery within 3 months. Since it’s been 6 months, it’s likely time to revisit the issue with your doc. Conservative, non surgical treatment includes things like rest, medications, physical therapy (especially core muscle strengthening).

If u choose a procedure, I personally favor kyphoplasty over vertebralplasty as it restores the bone mass, so lesser chance of a “hunched” back. My grandmother had a compression fracture that was very disabling. She lived very far out in the country, in a coal mining town. I brought her to my place, with a large regional hospital. The interventional radiologists did kyphoplasties daily (I think that it is key to ask how often your procedure is done). She breezed through it, took no time at all. She was almost immediately pain free and asking to return home.

Regardless of how you decide to treat this fracture, a compression fracture without serious trauma is enough to make the diagnosis of osteoporosis. So that means you are at risk for further fractures. Discuss treatment with your doctor. Learn about osteoporosis. Have blood work that includes a vitamin D level. Modify your diet. Ensure you are getting adequate calcium, vitamin D, vitamin K2. Weight bearing exercise is important. Quit smoking if u have this habit.These are just cursory recs. As you learn more about osteoporosis , you can adapt your strategy. I don’t want to overload you immediately lol

There are many posts here on mayo about osteoporosis.

Good luck

I fell backwards on my cement garage floor and sustained a compression fracture of L2-L3 in 2010. I was in bed for a few days before I could get to the ER and over a couple years the pain went from mild to moderate and eventually extreme. I had surgery on March 7th, this year and the surgeon said it was worse than imaging had shown (the bone was pushing on the spinal cord) so he did a triple laminectomy with a fusion of L2-L4. I am still having trouble walking and pain is no
better but at 77 years old, my bones have seen better days. The compression caused issues with my bladder and bowls as well that have not yet resolved.

thanks for your response, i passed out and fell backward and came to after my butt hit the floor with excruciating pain. Not being conscious prevented me from bracing my fall. I went to the chiro after a month and a half and that was probably not a good idea after no resolve I ended up seeing the doc.

i hope you feel better soon. thanks for your response.

Did the doc do an evaluation for the cause of your passing out? I sure wouldn’t want it to happen again!

Laura is right, you need to figure out what caused your syncopal episode so you don’t repeat your injury. You’re a very lucky guy in that you aren’t debilitated in any way from your fall and subsequent injury. You should be very happy nothing worse occurred and consider seeing a PT for an evaluation once you’ve ruled out everything else.

Hi, I also just fell directly on my behind onto a hard ground (was standing on a bed; not a good idea). CT scan and x-ray show an L1 (endplate) compression fracture. I'm not sure if it was my mother's prayers or what, but I went from excruciating pain (Days 1-3) to barely any pain at all (end of Week 2). BUT, I also prepared for the worst before I got the radiologist report, log roll into/out of bed, do not pick up anything heavy or twist my back. I also lay down flat mostly unless I had to get up and eat/go to restroom in Week 1, lay down flat + walk/stand (75%, 25%) in Week 2, lie:stand/walk 50:50 in Week 4, and now 25:75 lie:walk/stand. I barely sit for > 15 min at a time to avoid pain, and absolutely will stay this conservative until after month 3. The reason why is how bone remodeling works. I'm not sure if vertebrae are any different, but it takes a good 3-6 months for a broken bone --> cartilage-like remodeled bone --> hard, mature bone. Even that initial remodeled bone (often pain free) is not considered risk-free, since it can be more flexible than mature bone, which can take another year or so. So I'm guessing 1-1.5 years before I do normal activities like jump or carry heavy weights. Due to lack of pain, it's easy to go overboard, but I am not about to be a statistic. Once you suffer a vertebral fracture, you waaay more likely to have another one (compared to those who never break it). So stay conservative, squat with a straight back and brace for short periods of times, and keep conservative for about a year, folks!

@sofiac7
I just had a Kyphoplasty yesterday for T-11 and L-1 fractures. Hard to say right now, but at least that pain is less(replaced by pain of procedure right now).
Hoping for a good recovery
Good luck to you
Regards,
Pam