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Spinal Fractures

 

What are Spinal Fractures?

Your spine is made up of 33 bones, called vertebrae, that provide the main support for your body, allowing you to stand up straight, bend and twist. In the middle of a vertebrae is a hollow space called the spinal canal, which provides a protective space for the spinal cord. The spinal cord relays messages between the brain and body. Spinal nerves branch off the spinal cord, pass between the vertebrae, and innervate all parts of the body.

A fracture of a vertebra can cause bone fragments to pinch and damage the spinal nerves or spinal card. Most spinal fractures occur from car accidents, falls, gunshots, or sports. Injuries can range from mild ligament and muscles strains to fractures and dislocations of the bones, to debilitating spinal cord damage. Many fractures health with noninvasive treatment, but surgery may be required in some cases.

Fractures can occur anywhere along the spine. 5-10% occur in the neck (cervical) region, while 64% occur in the low back (thoracolumbar) region. There are numerous classifications for fractures. In general, spinal fractures fall into three categories:

  • Fracture – when more pressure is put on a bone than it can stand, it will break. The most common type of spine fracture is a vertebral body compression fracture. Sudden downward force shatters and collapses the body of the vertebrae. If the force is great enough, it may send bone fragments into the spinal canal, called a burst fracture.

People affected by osteoporosis, tumors and certain forms of cancer that weaken the bone are prone to compression fractures. This fracture appears as a wedge-shaped collapse of the vertebra.

  • Dislocations -- when the ligaments and/or discs connecting two vertebrae together are stretched or torn, the bones may come out of alignment. For example, when the rapid forward motion of the upper body against a seat belt pulls apart the vertebra and stretches the ligaments. A dislocated vertebra can cause instability and spinal cord compression. They usually require stabilization surgery or a brace.
  • Fracture-dislocations – occur when a bone is broken, and the ligaments are torn. These fractures are usually unstable, tend to be very debilitating, and are often surgically repaired.

Symptoms of Spinal Fractures

Symptoms of a spinal fracture can vary depending on the severity and location of the injury. These can include:

  • Back and neck pain
  • Numbness
  • Tingling
  • Muscle spasms
  • Weakness
  • Bowel/bladder changes
  • Inability to move (paralysis)

Paralysis is a loss of movement in the arms or legs and may indicate a spinal cord injury. Not all fractures cause spinal cord injury and rarely is the spinal cord completely severed. If you believe someone is suffering from a possible spine fracture, it is crucial not to move them until medical personnel can examine to avoid any long-term harm.

Diagnosing Spinal Fractures

In most cases of a spinal injury, paramedics will take you to the emergency room (ER). Doctors will assess your breathing and perform a physical exam of the spine to identify any changes to the shape of your spine and posture. Your provider will likely need imaging tests of your spine to determine your diagnosis:

  • X-ray – to confirm a fractured spine and show how out of place your bones are.
  • MRI – to capture a complete image of your back and show possible damage to tissue and vertebrae.
  • CT scan – to determine how damaged the bone and surrounding tissue are.

The spine is kept in a neck brace or back brace until appropriate diagnostic tests are complete. 

Treatment of Spinal Fractures

How your spine is treated will depend on a few factors, like the cause, the type and where in your back the broken vertebrae are. Most spinal fractures don’t require surgery. Your provider will likely recommend noninvasive treatments first, such as:

  • Bracing – to hold your spine in alignment and help your broken vertebrae heal properly.
  • Physical therapy – to strengthen the muscles in your back and reduce the risk for future fractures.
  • Treat osteoporosis – to strengthen your bones to prevent future fractures.

If your spinal fracture is in danger of damaging your spinal cord, or pain doesn’t improve with noninvasive treatments, your provider may recommend surgery. There are two common types of spinal surgery, which your surgeon will explain which you require and why. These include:

  • Vertebroplasty – your surgeon injects liquid cement into your fractured vertebrae to strengthen it.
  • Kyphoplasty – similar to a vertebroplasty, but before injecting liquid cement into your vertebrae, a tiny balloon is inserted to push your bones back into their correct place and re-create the space that was there prior to the fracture.

Most people start to feel better a few weeks after starting treatment. Most spinal fractures heal in around three months if you did not require surgery. For those who did require surgery, it may take as long as six weeks to recover from surgery, then a few months to heal. Recovery will vary depending on which type of fracture you have, which vertebrae were broken, and type of treatment.

Risk Factors of Spinal Fractures

As with any procedure, certain risks are associated with spinal fracture surgery, including:

  • Failure to repair the fracture fully.
  • Spinal cord damage.
  • Bleeding.
  • Infection at the injection site.
  • Increased stress or vertebrae around the repaired bones.

If you experience any new symptoms or changes in your back, such as pain, swelling, discoloration, or tenderness, contact your healthcare provider right away.