What Is a Spinal Fracture?
A spinal fracture is the breakage of one or more of the vertebrae that make up the spine. These fractures vertebrae can be anything from a tiny fracture that results in just back pain to a severe fracture that endangers the spinal cord and the nerves. They can occur anywhere from the neck to the lower back region; however, some sections have more chances of sustaining these fractures than other sections. Their severity will depend on the degree of collapse, stability, and involvement of the nerves. Doctors classify such injuries based on their vertebral fracture types, and getting the correct backbone fracture treatment requires knowing what type of fracture you have.
Types of Spinal Fracture
Vertebral fracture types can be determined based on the fracture and stability of the spine.
Compression and Wedge Fracture
In a vertebral compression fracture, the front part of the vertebra breaks down while the posterior remains intact, resulting in a wedge-shaped vertebra; hence the term “wedge compression fracture.” It is the most common type of vertebral fracture that occurs following a fall or poor bone quality.
Burst Fracture
Burst fracture results where the vertebra breaks outwards due to significant forces, for instance, from falling or car accidents. This may lead to compression of the spine or nerves and become an unstable condition that would need surgical correction.
Fracture Dislocation
In the case of a fracture-dislocation, the fractured vertebrae will also be displaced relative to its adjacent vertebrae. It is the least stable variety of all and will need surgery.
Spinal Fracture by Level: D12, L1 and L2
In India, D12 is normally used to refer to the dorsal 12, whereas T12 is the international way of writing thoracic 12. Both refer to the same vertebral level, the last vertebra of the upper and middle back, so that D12 compression fracture and T12 compression fractures refer to the same problem. D12 and L1 are the vertebral levels which are most often fractured because they form the junction between the rigid thoracic spine and the flexible lumbar spine. Force is transferred through the rigid column and localized at the point where motion starts; this is why D12 vertebra fracture occur often due to falls. L2 lies immediately below, taking the same amount of force; this is why L2 fractures occur. Neck bone fractures are not as common as hip bone fractures, but when a cervical bone fracture is broken, it is an emergency situation due to the close location of the spine.
Spinal Fracture Symptoms
Spinal fracture symptoms which vary depending on their cause. The main symptom is back pain that starts suddenly and becomes worse with standing, walking, or bending. In case of compression fracture spine, loss of height, stooped posture, and sensitivity over the fractured bone could also occur. There may be tingling, numbness, or weakness in the legs as a result of burst fractures or fracture dislocation. Loss of bladder or bowel function or sudden weakness in the legs following trauma is an emergency. Some fractures that occur in osteoporotic bones will cause little pain.
What Causes a Spinal Fracture?
There are two primary reasons for a spinal fracture. High impact injuries such as road traffic accidents, falls from heights, or sporting accidents can cause a burst fracture in healthy bones. Weak bones and osteoporosis are the main causes for older people, where a mere fall or even coughing can lead to a broken vertebra. Another cause is metastatic cancer that spreads to the spinal vertebrae causing weakening and eventually collapse.
How a Spinal Fracture Is Diagnosed
X-rays are taken first to view the fracture and the alignment of the spine, followed by a CT scan to view the bones and the pattern of the fracture. The MRI scan helps in viewing the condition of the spinal cord and the nerves. This is also the scan that determines if a fracture is acute and hence determines the course of treatment. It may be used to exclude other reasons for vertebra collapse, such as spinal infection.
Spinal Fracture Treatment Options
The spinal fracture treatment is dependent on the type of the fracture, stability, nerve damage and general bone condition of the patient.
Bracing and Non-Surgical Care
Pain medication, use of a back brace for weeks, and physiotherapy are the methods used in the management of stable fractures like compression fractures. Most cases of vertebral compression fracture treatment heal naturally when affected by the above treatment method.
Vertebroplasty and Kyphoplasty
Vertebroplasty and Kyphoplasty become useful when pain persists even after bracing. It includes the use of bone cement injected into the damaged vertebrae through a tiny incision. In Kyphoplasty, however, a balloon is used to restore height before injection of bone cement.
Surgery
Burst fractures, fracture dislocation and any fracture that impacts the nerves is surgical. Nerves are decompressed and the spine is stabilized using screws and rods, with spinal fusion as needed, as well as spinal reconstruction surgery if there is extensive damage to the vertebra. Dr. Zahir Abbas Merchant, who has 15+ years of experience in orthopedics, prepares his patients according to the scans and general health of the patient.
Spinal Fracture and Osteoporosis
Osteoporosis is the most common cause for an older individual to sustain a vertebral fracture because weak and porous bones may give way to the daily stress. The occurrence of a first spinal fracture due to bone weakness is also a red flag for further fractures to occur and thus needs to be assessed via a bone density test. Treatment consists of calcium, Vitamin D, bone-strengthening drugs, physical exercise, and fall prevention.
When to See a Spine Doctor
Visit a spinal surgeon if you have had any trauma that resulted in back pain, or if back pain occurs unexpectedly at any age without any prior history of trauma. Numbness of legs, weakness of legs, or loss of control of your bladders and bowels require immediate attention.
It is important to be examined early since the fracture might heal in the collapsed state or put pressure on the nerves. You may visit The Spine eXpert Clinic in Mumbai headed by Dr. Zahir Abbas Merchant, an orthopaedic and spinal surgeon with more than 15 years of experience in orthopaedics. He will examine your X-ray, CT, and MRI reports all together, initiate braces and physiotherapy if the fracture is stable, and suggest surgery only in case of unstable spine or nerve pressure.
Frequently Asked Questions
How long does a spinal fracture take to heal?
Most stable fractures take around eight to twelve weeks to heal, but you should experience less pain before that time. Other factors such as surgical fractures and weak bones may cause the healing process to take longer,and your physician will establish the healing through further tests.
How long should I wear a back brace for a compression fracture?
Usually it takes six to twelve weeks but it varies depending on the type of fracture and the physician’s advice. The brace helps the bone heal in the spine, and you should take off the brace slowly and build your muscles in your back.
Does a spinal fracture always need surgery?
No. Stable compression fractures usually heal by wearing a brace and taking painkillers along with physiotherapy. Unstable fractures, nerve compression and very painful fractures not responding to conservative treatment require surgery. In case of any doubt, Dr. Zahir Abbas Merchant can be consulted who has 15 years of experience in orthopaedics at The Spine eXpert Clinic in Mumbai.
How should I sit with a fractured vertebra?
You need to sit straight up in a stiff chair where your back is properly supported and the feet remain on the floor. According to your doctor, shorter periods of sitting and walking about while refraining from lifting and twisting are recommended.