Spinal Fractures Overview
A spinal fracture or dislocation of one or more vertebrae in the spine can cause bone fragments to pinch, damaging the spinal cord or surrounding nerves. Most spinal fractures occur because of a high velocity accident and can involve the neck (cervical), mid-back (thoracic), or lower back (lumbar). A spinal fracture is considered a serious orthopedic injury, associated with trauma from motor vehicle accidents, a fall from a height, or a sports injury. Depending on the severity of your injury, you may experience moderate to severe pain, difficulty walking, or the inability to move your arms or legs (paralysis). Many fractures can heal with conservative treatment; however, surgery is sometimes required to realign the bones.
What Causes a Spinal Fracture?
Spinal fractures can occur due to a variety of factors. When an external force is applied to the spine, excess pressure is placed on the bone within the vertebral column. This may cause the front part of the vertebral body to crush, resulting in a compression fracture. If the entire vertebral column breaks, it is known as a burst fracture. Other risk factors related to fractures include cancer and osteoporosis, a disease which causes the bones to weaken over time.
Types of Spinal Fracture Patterns
There are 3 major types of spine fracture patterns: Flexion, Extension and Rotation. Raleigh Orthopaedic spine specialists classify fractures of the thoracic and lumbar spine based on a specific pattern of the fracture and whether there is a spinal cord injury. This classification helps determine the proper treatment for the spinal fracture.
The flexion fracture pattern includes both compression and axial burst fractures. With a compression fracture, the front (anterior) of the vertebra breaks and loses height, while the back (posterior) part of it does not. This type of fracture is usually stable – the bones have not moved out of place – and is rarely associated with neurological problems. With an axial burst fracture, the vertebra loses height on both the front and back sides, and can sometimes result in nerve compression. Some are stable, while others are significantly unstable.
A flexion/distraction (chance) fracture is characterized by the extension fracture pattern. In this type of fracture, the vertebrae is pulled apart, causing what is considered to be an unstable fracture. A chance fracture can occur in a head-on car collision when the upper body is thrown forward while the pelvis is stabilized.
The rotation fracture pattern includes the transverse process fracture and fracture-dislocation. Transverse process fractures result from rotation or extreme sideways (lateral) bending. However, they are uncommon and seldom affect stability. A fracture-dislocation involves the bone and/or soft tissue in which a vertebra moves off an adjacent vertebra. This injury frequently causes spinal cord compression.
Symptoms of a Spinal Fracture
Symptoms of a spinal fracture will vary depending on the severity and location of the injury. A fracture of the thoracic or lumbar spine causes mild to severe back pain that worsens with movement. If the spinal cord or nerves are involved, the patient may experience:
- Weakness in the limbs
- Muscle spasms
- Bowel/bladder dysfunction
Spinal Fracture Diagnosis
Vertebral fractures are diagnosed via X-ray in the respective location of the spine – neck, mid back, or low back. Then, your orthopedic specialist will generally order a CT scan to visualize any changes in the bone structure. In some instances, an MRI may also be performed to evaluate the surrounding soft tissues, ligaments, and intervertebral discs, or to identify an injury.
Treatment Options for Spinal Fractures
Treatment for spinal fractures usually begins with pain management and stabilization to prevent further injury. Most minor fractures can be treated with cervical bracing to maintain spinal alignment, immobilize the spine during healing, and control the pain by restricting movement. After about 8 to 12 weeks, the brace can be removed.
More complex fractures or fractures with spinal cord compression may require surgery to ensure proper healing. The goal of surgery is to fuse and repair the fractured vertebrae, eliminate back pain, and restore posture and ease of movement. The most common surgical treatment options for spinal fractures are lumbar fusion and vertebroplasty/kyphoplasty. Lumbar fusion is a minimally-invasive procedure which joins the bones of the lower back using rods.
Vertebroplasty and kyphoplasty are more advanced, image-guided procedures performed in an X-ray suite or operating room with supporting X-ray equipment. In both of these surgeries, the neurosurgeon is able to reconstruct compressed vertebral bone, remove pressure on a nerve, and restore alignment.
What is the Recovery for a Spinal Fracture?
Regardless of whether a patient undergoes nonsurgical or surgical treatment, there will be a period of rehabilitation after the fracture has healed. For most spinal fractures, surgery is not needed and many patients respond well to conservative therapies such as bracing. Generally, you should avoid any intense physical activity for 12 weeks to allow the body to fully recover. Your doctor may recommend treatments to address bone density loss during this period and will carefully monitor the injury for any changes.
Schedule an Appointment at Raleigh Orthopaedic in the Triangle Area
Raleigh Orthopaedic Clinic is committed to providing patients with the highest quality care for a wide range of orthopedic conditions and injuries. Serving Wake County since 1919, our team of board-certified physicians and advanced practice providers has the knowledge and expertise needed to help restore your body to optimal health. If you are seeking immediate care, please visit one of our urgent care centers nearest you. To meet with one of our orthopedic specialists, you can schedule an appointment online or call us directly at (919) 781-5600 today. We look forward to helping you live a more active and comfortable life!