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Spinal Fracture

New York Spinal Specialists

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+ Spinal fracture

Patient Education

The spinal column is made up of 33 bony segments stacked on top of one another. These segments, called vertebrae, have an inner layer of soft bone and an outer layer of hard bone. The round portion of bone at the front of each vertebra is called the vertebral body.

The bones in your spine aren’t as dense as some of the other bones in your body. For example, the bones in your legs are designed to withstand rigorous movement and force. In contrast, the bones in your spine are smaller and more “flexible” in order to accommodate a variety of movements such as bending or twisting.

This difference in bone architecture is one reason the bones in your spine are more vulnerable to fracture.

A spinal fracture is referred to as a vertebral compression fracture because when a vertebra breaks, it typically collapses and becomes compressed.

Spinal column segment illustrating the vertebral bodies (left).

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Patient Education

Causes of spinal fracture

Advanced age

Osteoporosis

Low bone mineral density

Long term use of medication, e.g., corticosteroids

Certain types of cancer; tumors

Trauma, i.e., car accident, fall, gunshot

Low levels of estrogen or testosterone

Sedentary lifestyle

Degenerative spine conditions

Osteoporosis is one of the most common causes of spinal fracture in adults.

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Patient Education

Men: Don’t underestimate your risk

Osteoporosis is not a disease exclusive to women. Men can have it, also.

In fact, over 2 million American men have osteoporosis and another 3 million men are at risk for developing the disease.

Osteoporosis can occur on its own or be caused by medication/other diseases.

Osteoporosis risk factors for men

Age > 50

History of alcohol excess

Low serum levels of Vitamin D

Prostate cancer with prolonged androgen deprivation therapy

Smoking, chronic obstructive pulmonary disease

Osteoporosis is a silent disease. Many people don’t know they have it until a fracture occurs.

+ More than just a broken bone

In some ways, a spinal fracture can be more debilitating than a broken arm or leg.

There is a hollow space in the the middle of each vertebra that houses and protects the spinal cord. Nerves branch off the spinal cord, passing between the vertebrae on their way out to the rest of the body.

Bone fragments from a fractured vertebra may compress and damage adjacent nerves or the spinal cord.

A spinal fracture also affects the alignment of the spine by shortening it and pushing it forward.

 

Vertebrae in the thoracic (chest) and lumbar (lower back) regions have the greatest risk for fracture.  

+ Symptoms of a spinal fracture

Sudden, severe pain related to trauma or specific activity

Mild pain that develops slowly, over time is a common symptom. This type of pain is often mistakenly attributed to aging or a simple backache.

Pain from a spinal fracture may be diffuse (spread out) or confined to a specific area. As a general rule, pain will worsen with movement. Sometimes there is no pain at all.

Multiple spinal fractures can cause stooped posture or a protuberance of the upper back, i.e., a dowager’s hump.

Height loss may occur with multiple fractures because, with each fracture, the spine shortens and tilts forward.

Picture your spine as a column of blocks stacked one on top of the other. If one of the blocks changes shape or collapses, it affects the entire column.

+ Did you know?

Spinal fractures are classified as either stable or unstable.

A stable fracture doesn’t cause significant alterations in spinal anatomy. The spine is still able to withstand weight and the spinal nerves are intact.

With an unstable fracture, vertebral deformity, nerve damage and spinal misalignment are common.

Left untreated, a fractured vertebra will usually heal on its own. The problem with this is that the bone heals in the fractured position.

It’s important to seek treatment if you suspect you might have a spinal fracture. Early treatment can help restore the deformed vertebra to its correct shape.

Men are 4 times more likely to have a traumatic spinal fracture than women.

+ Types of spinal fracture

Burst fracture Generally caused by trauma (fall, car

accident, etc). A burst fracture is a significant injury that crushes the entire vertebra. Bone fragments are displaced and spinal cord injury may occur.

Patient Education

Compression fracture Sudden downward force causes the

vertebral body to collapse. This type of fracture is common in people with osteoporosis or other conditions that cause bone loss.

Wedge fractureSimilar to a compression fracture except that only one part of the vertebral body collapses. The vertebra then becomes wedge-shaped.

Almost half of all spinal fractures are caused by car accidents.

+ How are spinal fractures diagnosed?

Patient Education

Spinal fractures can be overlooked during routine exams and often go undiagnosed. If you have back pain unrelated to specific injury, talk with your doctor about an X-ray.

However, be aware that spinal fractures aren’t always visible on X-ray.

If your X-rays are negative, but your back pain persists, Magnetic Resonance Imaging (MRI) is a reasonable next step.

In certain cases, Computed Tomography (CT) may be ordered.CT is useful for viewing soft tissue and changes in bony structures.

Evaluation of both the clinical findings and imaging studies lead to accurate diagnosis.

+ Nonsurgical treatment for spinal fracture

Treatment goals for spinal fracture include:Management of pain

Stabilization of the fracture

Typical treatment regimen

Pain medication

Back brace – maintains spinal alignment; controls pain by limiting movement

Rest

Gradual return to normal activity over a period of 8 –12 weeks.

Many patients with spinal fracture respond well to nonsurgical treatment.

Patient Education

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Patient Education

Minimally invasive treatment

Vertebroplasty and Kyphoplasty are two minimally invasive procedures for the treatment of spinal fracture.

Both have been shown to significantly reduce or eliminate spinal fracture-induced back pain, sometimes immediately after the procedure.

For patients with significant loss of vertebral height and/or instability, spinal fusion surgery will most likely be recommended.

Many minimally invasive procedures offer the possibility of same day surgery and less down time.

+ Vertebroplasty vs. Kyphoplasty

Patient Education

How they’re similar

Under fluoroscopic guidance, a biopsy needle is inserted through a small incision in the patients’ back.

The physician injects bone cement into the fractured vertebra.

The cement dries quickly, creating an internal cast that stabilizes the fracture.

How they’re different

During vertebroplasty, bone fragments are cemented together in the fractured position.

With kyphoplasty, balloons are first inserted and inflated inside the fractured vertebra.

Inflating the balloons expands the compressed vertebra and restores its normal shape, in as much as possible.

The balloons are removed and the cement is injected.

Vertebroplasty and kyphoplasty can often be done on an outpatient basis with the patient under light sedation.

+ Surgical fusion for treatment of spinal fracture

Spinal fractures that cause neurological problems require immediate intervention to stabilize and align the spine.

The surgeon may recommend spinal fusion – a procedure that “fuses” two vertebrae together with hardware and/or bone graft.

The goal of surgical fusion is to restore spinal stability and return the patient to an optimal level of function.

After surgery, it takes several months for the fused vertebrae to form one solid segment of bone.

Abnormal movement between two vertebrae can damage the spinal cord and nerves.

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Patient Education

Don’t ignore back pain

Once you have a spinal fracture, your risk for another is significantly increased.

Self-diagnosis or thinking, “It can’t happen to me” will not work to your advantage in the long run.

Be smart. If you have back pain and/or risk factors for spinal fracture, make an appointment to see your doctor right away.

Early detection and treatment are the keys to living well.

Treat a spinal fracture the same way you would treat a broken arm. If it’s broken –

fix it.