How to tell how old a vertebral fracture is?

Hi- I had an MRI and a DXA scan fall 2011 and both said that there was "evidence of a previous compression fracture with mild anterior wedging at T12". But I also had xrays about a month prior and it said "some anterior spurring" at T12- but didn't mention a fracture. I also had xrays about 6 months before that and those xrays said nothing about T12 whatsoever.

So I am wondering how long it takes for "anterior spurring" to occur (that is osteoarthritis from the fracture I guess). Like, could the fracture have occured 5 months prior and the spurs grow in only 5 months?

This question is really important to me and my doctors, God love them, just don't know this sort of thing. My back continues to really kill me. I am exercising, doing everything I can. I keep hoping that the pain is just because I am improving my posture. It would really help me to figure out what is wrong if i was to know when the T12 fracture occurred. If it occurred 20 years ago, I will just stop worrying about this pain.


***Also***, for the life of me I forget the term for the extra analysis you can ask for from a DXA scan to check for fractures. I did not have that done. My pain is more around T7-T3 and neither the MRI or DXA scan checked this area. I have a doctors appointment on Monday and plan to beg him to send me back for this analysis, but I can't remember what it is called!!! I tried googling. Also, don't know if this analysis will be able to date any fractures it sees.

Thank you very much. I just really am so tired of this pain and not knowing what it is. Of course I am scared the pain is my spine crumbling, lol, and I feel that if I knew it was ok, it would not affect me as much. Like, the fear is worse than the pain.

thanx

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well I just talked to the DXA technician and she was nice enough to explain a lot to me-

They already did that "extra" scan on me- it is just a lateral view. This hospital does the lateral view on everyone because the machine easily rotates or whatever so it is not really any extra effort for them. That is how they found the "fracture".

She said they look at the spine in the lateral view all the way up to about T1, even maybe into the cervical. But she said the higher up it looks, the harder it is to see because there is stuff in the way such as the lungs etc. So while my scan was able to detect a "mild fracture" at the T12 level, it may not be able to detect a mild fracture at the T3 level.

So I also asked her if there could be confusion between the September xray that said anterior spurring at T12 and the DXA that said mild compression at T12. She said yes, and to go with the xray results over the DXA scan because xrays show things more clearly. But then I told her about the MRI in December saying I had a probable fracture at T12 and she said that I should then follow the MRI results. I asked her if the radiologist who looked at the MRI results could have been influenced by the DXA results and she said no, that they are not allowed to look at other results until after doing their interpretation on the current test.

So I guess it is pointless to go back for another DXA.

She also said that realistically, post menopause, it is all "downhill from here". LOL. Even with HRT I really should not expect any increase. I said, well -2.6 really isn't that bad, and she said for my age, yes it is.



****************************But I still have 2 questions****************************************

1)how long does it take anterior spurring to occur? (she could not answer this)

2) I forgot to ask her this- I had an xray 5 years ago that said nothing. Then the xray I had in September did a comparative view with that older xray, and it said "NO CHANGE IN VERTEBRAL HEIGHT". Does that also mean no change in the shape of the vertebrae?

My back is really killing me.

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HighImpactLover
First, I think you need to take some serious pain medication, back pain that is 'really killing you' is not good. Just find something (or ask the dr) that will take the edge off, and try heat too, I find that helps, a very hot shower, and I also use a 'heat sack' (a cloth bag filled with grain that can be heated in the microwave). The heat brings more blood and therefore quicker healing to the painful area.
Meanwhile, until that pain has subsided, DON'T do anything too strenuous! Gentle walking, gentle stretching ON THE FLOOR so that your back is supported, deep abdominal breathing while lying down so that your muscles relax. That is all you can do until the pain has eased.
I see a very knowledgable osteopath regularly, she is great for giving me exercises etc BUT she says when in great pain to ONLY do relaxing and gentle stretching, NO STRENGTHENING exercises, otherwise it is so easy to make it worse.
If your found fracture is at T12, yet your pain is around T3-7 then I would think they are unlikely to be related. Either you have a new fracture around T3-7 or it is something else entirely.
Either way, give up strenuous exercise until the pain eases. I find, with a new spinal facture that takes about 12 weeks, sounds awful I know but i'm used to it now (I've had 7) and I know what medications I need to cope.
good luck and let us know how it goes.
Oh, and I would think 'no change in vertebral height' in those 5 yrs indicates that you did not have a fracture during that time.

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HighImpactLover
I think the name you are looking for is vertebral fracture assessment which can be done in addition to the dexa .... at the same time as the dexa.
Post menopause .... all downhill from here? Was she joking with you? That's a terrible attitude. I know women in their 70's & 80's that are enjoying their life ..... even with some health situations. I believe that the body wants to heal .... but we need to find out what our bodies need to support that healing. Then we continue on with our lives with hopefully a good quality of life .Take care
Sandi

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Thank you SDivas- she said the bone density was all down hill from here. She was quite nice. But I am personally feeling a bit the other way. But things will improve, I know that, thanx.

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Thanx arrowsp-

well this is why I am so hugely confused.

1)In April 2011, xrays said NOTHING about T12. I have a copy and I can see the vertebra is a little wedge shaped- not much. I read some wedging is natural!
1)In September the xray comparing it to one 5 years ago says no change in vertebral height and anterior spurring at T12
2)In late October, the DXA scan says probable mild fracture at T12
3)In December, MRI says probable fracture at T12

actually I am not 100% sure what the MRI says because I only have the neurologists interpretation of the radiologists interpretation, so maybe the neurologist misunderstood something. I am going to be phoning her office on Monday to get the actual written MRI results.

But still confused. Maybe in denial. But maybe not!

Regarding the pain and exercise, I am so so so confused. I wake up every morning just fine. Like clockwork, sometime between noon and 3 pm the pain begins. So I am thinking it is some sort of intense fatigue from NOT hunching over at my desk- I mean, my posture now is better than it has ever been because I am really focusing on it. So I am also doing back exercises to strengthen my back- make it stronger so it doesn't fatigue. No flexing, I keep really straight- I am doing a lot of chest supported rows.My back is usually stiff afterwards but not painful- like the muscles tighten right up but not the same sort of pain that happens at 3pm. I am getting really strong too, like up to about 90 pounds on some machines, and yet, not one iota in the change in this pain pattern- by 3pm, I'm done. I have been doing the weights since January. And I hate to say it but the only time my back seemed to improve was for the 6 weeks I was taking strontium citrate, I really really hate to admit that, maybe strange coincidence.

Anyway, so if the pain is caused by fatigue I am in a big Catch 22 over the back strengthening exercises- I get so afraid of actually making things worse but it is the only way I see of getting any better.


Thank you for saying that about NO CHANGE IN VERTEBRA HEIGHT likely means no fracture- I mean, the radiologist had the xrays taken on the same machine, both right in front of her, she would have seen a change!!!! So either I got a fracture between September and late October- which is possible as I was getting adjusted by a chiropractor and getting lots of pain- or something is just way off. My back pain started last April. I actually went to a drop in clinic last night and asked a doctor what this meant and of course he had no clue.


Thank you for saying that pain at T3 is likely not related to T12. I am saying T3. Geesh, I don't know. I actually got a physiotherapist to draw dots on my back last year to identify the actual numbers- where each number is etc. I should have taken a picture but she seemed oddly underconfident- like didn't seem she really knew. And really I am out of money-


Re pain meds, I really rather know what is going on. But that is a very good tip about the heating pad- I am DEFINITELY going to start doing that!! That is another reason I do the rowing exercises- to get some blood in the area.

I am going to take a picture of my back and post it with a circle around the area- I drew a circle on it yesterday before I went to the clinic, LOL, but we didn't even get that far-

I also got quite a wake up call yesterday- both this doctor and the technician sort of said that -2.6 at my spine at my age **IS** serious. I keep poo pooing it because it is just on the border, like so in denial, but the tone of both their voices really was- this is serious. Pretty scary. I really hate this. My mother had osteo but I am not even sure it was as far as osteoporosis- she went on fosomax. But my father died when I was young and my mother broke off all ties with them so I really have no idea what is on his side of the family.

sorry for the ramble.

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I wanted to say my mother lost height but never fractured and was in great health etc up into her 80's, playing tennis ,always good posture.

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here is my back! (LOL)
so the pain radiates out from the dot and the muscles tighten. Last night was the first time even the muscles tightened over the sides of my rib cage- but that didn't last too long, it normally stays in my back.

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which T does that look like? T6 or T12 ? Thank you ! I look at diagrams but really hard to say on me.

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I think T12 would be quite a bit farther down, wouldn't it? Just before the lumbar ones start, and there are only 5 of those.

Regarding your afternoon pain.....
my guess is that your back, by that time of day, feels tired and starts to sag (mine does anyway) and responds with pain. I think at that point, or preferably before you feel the pain, you should maybe do some lying down and stretching and relaxing exercises. Lying on the floor is wonderful therapy for your back, at least that's what I find. So give your back a break! It can't stay straight and upright all day long, you need to learn when its had enough.
(Warning....just before Christmas, when I was busy rushing around doing things, staying on my feet too long, etc, I didn't listen to my back one day, ignored the tired feeling, kept going....and yes, sure enough I got another fracture.....sigh)
When you are sitting 'with a straight back' are you also using a back support in your chair? I think its a good idea to use one.

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Hello HIghImpactLover,
I was just wondering after reading your statement "And I hate to say it but the only time my back seemed to improve was for the 6 weeks I was taking strontium citrate, I really really hate to admit that, maybe strange coincidence." why you no longer take it? Did it bother you, or give you a reaction of some sort?
Lorrianne

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I think I read some where on this site about how, or if, a fracture can skew the results of DEXA test, but I cannot find it again! Does anyone know about this? My spine was -3.7 but had a recent compression fracture in L4 area. I have just wondered recently if my results could be better, or worse, being done at a time when there was a fracture.
Just something new to wonder/worry about I guess! :)
Lorrianne

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well I am not the expert on this you might like to start a separate thread and maybe DXguru will see it

but my understanding is that a compression fracture compresses the bone, and that makes it more dense, so that would increase the scores, though maybe the software is intelligent enough to take this into account.

That is the same reason why arthritis can artificially raise (improve) the bone density reading because it makes the bone look more dense.

Also why arthritic could possibly be confused with a compression fracture which I really really really hope is the case with me.

so my answer is it makes the results better. maybe pm dxag and ask him

I have not reponded to arrow yet! I am sorry, just not up to talking about myself right now. My back was mysteriously better yesterday and today and I got your pm- and yes I need to look into that. I say my back was 'better" in that it was not as bad as Friday but it is not the way it was a year ago. I guess this non stop tightness etc is just my new reality. It is still sort of surreal to me. I thought i would be young forever. I mean I knew I would get wrinkles, but I don't care so much about that but never thought that this would happen.

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ha sorry I didn't even see your response! I stopped because I am also taking HRT and I read one of the original research papers on strontium ranelate. In the beginning (2002 approx) they tried the drug on a variety of post menopausal women ranging in age from I guess mid forties to way over 70 years of age. And they found that it did not reduce the fracture risk that much for the younger post menopausal women. I forget the actual number. I will have to look at that again. I think it reduces fracture risk by about 40% for the older ladies but only 20% for the younger ones. 20% reduction is starting to look not so bad, but there are other issues too, such as the reputation of this company's research (Servier)- there was a scandal involving one of their other drugs, so then that puts into question the strontium research. Plus the fact that the density increases are largely not real and it will screw up any subsequent determination over whether the HRT is working.


Really, it was a risk versus benefit decision. HRT & strontium have never been studied together. Strontium has never been studied on men or premenopausal women. Strontium ranelate is prescribed more for the older post-menopausal woman. It benefits the younger woman to a lesser degree. The actual improvement in density is unknown. It has not been studied for longer than 8 years and most of which was done on women 70 years and older. The required dosage is 70 times greater than what is found in the diet- regardless of what anyone says, in my mind, it ain't no supplement, it is a DRUG.

I also became aware that a number of posters here are actually marketing strontium citrate. At first, I assumed that every poster on this site was just like me, a regular person looking for the truth. But there were a couple of really obviously paid posters here pushing strontium citrate in a really absurd and unscientific manner, with very colorful writing that just smacked of paid marketing schemes. One in particular kept saying strontium citrate is better than strontium ranelate because the latter is "chemicalized". I mean that is just absurd language and she seemed to be on a real mission to push these ideas. The whole thing has just made me think of "sleaze" when I think of strontium citrate. lol

So that made me requestion all the information I had taken as friendly advice. I mean, when I begin to catch these people in outright lies and misinformation, it puts into question what *everyone* has said. So I just re-evaluated with that in mind and decided against it.

I am also disgusted by certain strontium citrate supplier's marketing. These companies are not regulated. Their strontium citrate could contain anything really- it is completely unregulated. Which,normally I would not be too worried about but coupled with really questionable marketing strategies, it puts a company's ethics into question. If their marketing is deceptive, do they really care about the quality of their product? A liar is a liar in all realms of life.

But I reserve the right to change my mind of course :)

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ha- Lorrieanne, I just realized you are the same person who joined recently and mentions Lara P's book to new people. I knew your name was familiar. Also mentioning the COMBS study, which is a very bad study btw.

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HIL, Thank you for your in-depth responses. I may try for an answer from DXAGURU. I wish I could help with a solution to your pain.
I have only been a member for a few months, but the people I see posting seem to genuinely want to help each other. I do promote Lara's book because I can relate to the fear new members are going thru and her book is a great place to start. It helped me to make immediate changes to my diet and life environment and gave me info on the natural route to fighting this disease. I have yet to find a dr who does not want to write me a prescription. I, like you, am only 50 years old and am not ready to take a medicine that will probably cause me new and worse problems down the road. My numbers are worse then yours, and due to my compression fracture I have to be more grounded with my exercise.
The only one profitting on me is swansonsvitamins! I must trust that the strontium I purchase from them is made with the same degree of regulation as their calcium, vit D, etc.
I feel the success stories posted on this site are truthful and are posted to help and encourage other sufferers, they do not push certain products, they simply state what has helped them. Why do you feel the COMB study is a bad study? And why do you have such strong feelings about members "pushing" certain vitamins or minerals, do you not feel that strongly about big Pharm?
Lorrianne

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Hi HIL, you've probably seen this, but in the absence of an answer for you I'll put it up anyway - sorry that you are in pain - http://www.spine-health.com/conditions/osteoporosis/diagnosing-vertebral-co mpression-fractures

Your reasons for not taking strontium are very sound. I wouldn't either in your position. Hrt will most probably help your bones, but you won't know that if your Dexa scores are skewed. One thing at a time. Also Hrt could possibly buy you ten years in which newer, better oste medications will have come on the market. I believe hormone treatment will improve in that time too, perhaps to the extent that there won't be the concerns about long term use.
Although I myself take strontium, I still have concerns and doubts about it. They still don't know exactly how it works. However I realize that I need to be on something and this seems the best option (after much research) at this moment in time. If there was a completely safe med with absolute proof of efficacy, we'd all be on that one! LOL Some have to be standard bearers, that's the way it is with medicine - or else we get nowhere fast in this battle/struggle for health.

And btw I think most reasonably savvy people can spot the agenda with some posters. But I feel that most on here are genuine and just want to share experience, help and be helped in return.

I hope you find an answer for your back pain. All the best.

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Oops forgot to say that I am -2.6 at spine too and I am 10 years older than you. Some have said that that's not so bad. But my doctor said "well, if you were 70 I'd say that wasn't so bad, but you will most probably live another 25 years or more, so it's not good. The fact that you are "young" makes it bad". Also like you and quite a few others on here I have osteoarthritis in my spine, which may mean that my scores are in fact a little worse than this.

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Hi :) well I just don't really know anything anymore. I don't really want to talk about supplements and big pharma, I really don't have a crystal ball so I will never be able to say anything with certainty but thank you very much for your responses.

I went to a different doctor today and he counted my vertebra going down from the top and the pain is originating at about T6. It is right in line with the bottom of my scapula. He has ordered a pile of blood tests plus a thoracic xray. He's not super knowlgeable about OP but he IS smart, I can tell, and he does do a thorough job so I feel good about that.

I am also getting a copy of the actual MRI. The neurologist who ordered the MRI wrote a letter to my GP at the time saying "The MRI showed a probably insufficiency fracture at T12 with minimal anterior wedging. You may wish to check a bone density, but there is nothing required specifically for this minor fracture. The conus medullaris and cauda equina were normal. The spinal and neuroforaminal canals are widely patent. She has only mild degenerative changes. No nerve root compression."

That was for the lumbar spine which I guess ends at T12.

I also found out she referred me to a specialist who I just looked up- the guy specializes in backs, he is a rheumy, and it sounds like he is quite well regarded. But the waiting list is over a year so I should get in some time around next Christmas.

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Glad you feel that doc is doing a thorough job. Shame you have to wait 'till around Xmas to see rheumy, but at least that's another investigation in the pipeline. Was anything mentioned about what you can do about pain in the meanwhile??

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I started UC-II 6 months ago and then 3 months ago Strontium Citrate. The 2 work on cartilage renewal and work in synergy together.

I am 62 yrs. have rheumatoid and tried all the conventional drugs, Methotrexate nearly killed me and the Prednisolone over the years has given all sorts of problems. Enbrell got to my nervous system and nearly shut it down and me dead !

After 2-3 months of UC-II my feet and left knee stopped clicking badly and my left foot only clicks ocassionally. 3 months ago I added Stron.Citrate and most of the pain in my sternum, ribs and upper back has gone.

I could not get Strontium Ranelate in Australia as I am not 70 yrs. and do not have a fracture. Ranelate acid contains Aspartame
and research shows this contributes to Alzheimers.

Critisize and support drug companies all you want - but do NOT poo poo something you have not tried. It might just work for you as it has for me and many others.

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