Spinal fractures result from car and motorcycle accidents, falls from a height, sporting injuries, osteoporosis, spinal tumors and high-energy trauma.
Overview
The injuries arising from such accidents range from mild strains of muscle and ligament to serious fractures of the spine and injury to the spinal cord.
Minor fractures that have not injured the spinal cord may be treated with rest, medication and a brace. Serious fractures require surgery; left untreated, they may lead to problems extending as far as permanent spinal cord injury.
Types of Fracture
Spinal fractures take many forms, but two types are seen most often.
- Compression Fractures
- Usually caused by osteoporosis, by a tumor or by other pathology of the spine.
- Burst Fractures
- A fracture in which the vertebral body is broken into several fragments.
Symptoms
The symptoms vary with the severity and the site of the injury. Not every fracture injures the spinal cord; paralysis may, however, follow high-energy trauma.
The commonest symptom is pain that increases with movement. The following may also be present:
- tingling and numbness;
- weakness or paralysis of the arms and/or legs;
- uncontrolled muscle spasm;
- loss of bladder and bowel control.
Diagnosis
Plain radiographs and computed tomography (CT) are used in diagnosis. Magnetic resonance imaging (MRI) is performed in order to establish injury to the soft tissues and to the spinal cord.
Treatment
The first step in treatment is to stabilize the patient. Spinal boards, cervical collars and braces are used to prevent movement of the injured region of the spine and spinal cord.
Once the patient is stable, imaging and examination determine whether surgery is required, according to the severity and the site of the fracture. Some minor fractures may be managed without an operation, with rest, a collar or brace, and medication.
Surgery is recommended where the spine has become unstable, where a fracture fragment is compressing the spinal cord, and where the spinal cord has been injured.
- Screw–Rod Stabilization
- The principal aims of surgery are to relieve the pressure exerted on the spinal cord by the fracture fragment or fragments, and to stabilize the spine with a screw–rod construct.
- Vertebroplasty and Kyphoplasty
- In certain cases, rather than being stabilized with screws, the fractured vertebra is strengthened by filling it with bone cement.