What Age Do People Get Vertebral Compression Fractures?

Oct 19, 2025 3 min read •

Geriatrics Orthopedics Osteoporosis

According to the American Association of Neurological Sciences, approximately 25% of all postmenopausal women in the U.S. will be affected by a vertebral compression fracture (VCF) during their lifetime. This statistic highlights that while VCFs can happen at any time due to severe trauma, age is the most significant risk factor, particularly in populations with osteoporosis, which answers the question of what age do people get vertebral compression fractures.

Quick Summary

The incidence of vertebral compression fractures increases significantly with age, with postmenopausal women over 50 being at highest risk, particularly those with underlying osteoporosis. The risk also increases for men over 50, but generally later in life and less frequently. Trauma and other medical conditions can cause these fractures at any age.

Key Points

Peak Risk in Later Adulthood: The risk of vertebral compression fractures increases significantly with age, most commonly affecting postmenopausal women over 50 and men over 65.
Osteoporosis is the Primary Culprit: Osteoporosis is the main cause of age-related VCFs, weakening the vertebrae and making them prone to collapse from minor stress.
Prevalence Rises Sharply with Age: Studies show fracture prevalence increases dramatically with each advancing decade, affecting 18-21% of people over age 80.
Trauma Can Cause Fractures at Any Age: High-energy trauma from accidents or sports can cause VCFs in young, healthy individuals with no underlying bone issues.
Pathologic Fractures Have No Age Limit: Cancers that spread to the bones can cause pathologic fractures at any adult age, regardless of osteoporosis.
Often Undiagnosed: Many vertebral compression fractures go undiagnosed or are attributed to general back pain, leading to potential height loss and spinal deformity over time.
Gender Disparity: Women face a higher risk, especially post-menopause, though older men are also at significant risk.

Age and Osteoporosis: The Primary Driving Factors

The most prominent factor determining when people get vertebral compression fractures (VCFs) is advancing age, primarily due to age-related bone density loss from osteoporosis. Osteoporosis, a disease characterized by weak and brittle bones, is the leading cause of VCFs, especially in women over 50. As bone mass naturally decreases over time, the vertebrae become more susceptible to collapse, even from minor forces.

Women over 50: This demographic faces a significantly higher risk due to hormonal changes following menopause. The decline in estrogen levels accelerates bone loss, making VCFs more common. Prevalence increases from around 25% in postmenopausal women to an estimated 40% by age 80 and older.
Men over 65: While VCFs are less common in men, the risk also rises with age. Hormonal changes and a general decrease in bone density contribute to this increased vulnerability later in life.
Prevalence by decade: Research confirms a direct correlation between age and fracture prevalence. Studies show prevalence increases steadily, from under 5% in people under 60 to nearly 11% in people in their 70s, and as high as 18-21% in those over 80.

Other Causes of Vertebral Compression Fractures at Any Age

While osteoporosis is the most frequent cause, VCFs can occur at any age due to other factors. This includes high-energy trauma in younger, healthy individuals and pathologic fractures caused by underlying diseases.

Trauma: Severe trauma, such as a car accident, a hard fall, or a sports injury (e.g., collision sports), can generate enough force to cause a VCF, regardless of age. This accounts for a significant portion of spinal fractures in younger patients.
Tumors: Metastatic cancers that spread to the bones of the spine can weaken the vertebrae to the point of collapse, leading to a pathologic fracture. This can occur at any adult age, and should be considered in patients under 55 with minimal or no trauma.
Other medical conditions: Prolonged use of certain medications, like corticosteroids, and other conditions that affect bone strength can also increase fracture risk at younger ages.

How Age and Fracture Risk Interrelate

The risk of experiencing a VCF is not static throughout life but changes based on a person's age, gender, and bone health. While younger people typically require significant trauma for a fracture, older adults with bone density issues can sustain fractures from routine activities.

Comparison of VCF Mechanisms Across Age Groups


Factor	Younger Individuals (Under 50)	Older Individuals (Over 60)
Primary Cause	Severe Trauma (e.g., car accident, major fall, sports injury)	Underlying Osteoporosis
Mechanism of Injury	High-energy impact on a structurally healthy spine	Low-energy trauma, or even routine activities like bending, coughing, or lifting
Bone Health	Typically healthy bone density and architecture	Decreased bone mineral density (osteopenia) or osteoporosis
Gender Predisposition	No significant difference based on osteoporosis, though trauma mechanisms may vary.	Women are at a higher risk than men, especially post-menopause.

A Hidden and Progressive Condition

A significant challenge with VCFs is that many are clinically silent or are mistakenly attributed to general back pain or arthritis, especially in older adults. As a result, up to two-thirds of osteoporotic VCFs may go undiagnosed. However, even asymptomatic fractures can increase the risk of future fractures and lead to progressive spinal deformities, such as kyphosis (a 'dowager's hump') and height loss. Therefore, persistent back pain, particularly in at-risk populations, should prompt medical evaluation to rule out a compression fracture.

Prevention and Management Considerations

Given the strong link between VCFs and osteoporosis in older age, prevention and treatment often focus on improving bone health. Measures include adequate calcium and vitamin D intake, regular weight-bearing exercise, and addressing lifestyle risk factors like smoking. Early diagnosis is crucial for effective management, which can include non-surgical methods or minimally invasive procedures like vertebroplasty or kyphoplasty to alleviate pain and stabilize the spine.

Conclusion

While vertebral compression fractures can result from significant trauma at any age, the risk increases dramatically in people over 50, primarily due to age-related bone loss from osteoporosis. The prevalence steadily rises with each decade, making these fractures particularly common in women over 50 and in both men and women over 65. Because many VCFs are undiagnosed, understanding this age-related risk is vital for timely medical assessment and preventative care to manage bone health throughout life.

Frequently Asked Questions

No, while the risk increases with age, VCFs are not a normal part of aging. They are typically a symptom of underlying conditions like osteoporosis or caused by significant trauma. Many are undiagnosed because patients or families mistake the symptoms for normal aging.

Osteoporosis-related VCFs most commonly affect postmenopausal women over age 50 and become increasingly prevalent with each decade. Studies show that by age 80, as many as 40% of women have had at least one VCF.

Yes, young people can get VCFs, but they are typically caused by high-energy trauma from events like a sports injury, car accident, or a hard fall, rather than underlying bone weakness.

Postmenopausal women are at higher risk due to a significant decline in estrogen levels, which leads to an accelerated loss of bone density and mass.

Osteoporosis causes bones to become weak, brittle, and thin. As a person with osteoporosis ages, their vertebrae can collapse and fracture from minor events, such as a cough, a sneeze, or simply bending over.

Having one osteoporotic VCF significantly increases the risk of future fractures. A prevalent or pre-existing fracture is associated with a 5-fold increased risk of another VCF, independent of bone mineral density (BMD).

Yes, men are also at risk for VCFs, especially older men over 65. While the risk is generally lower than for women of the same age, it remains a major health concern for this group due to age-related bone density loss.

References

Medical Disclaimer

This content is for informational purposes only and should not replace professional medical advice. Always consult a qualified healthcare provider regarding personal health decisions.