Spine fracture

Specialty of Orthopaedic surgery

What is a spinal fracture?

A spinal fracture is a break or collapse of one of the bones of the spinal column. It is a serious lesion. A fracture can occur in any part of the spinal column. Generally, spinal fractures are divided into three categories:

  1. Compression fractures: Occur when more pressure is put on a bone than it can withstand, causing it to break.
     
  2. Dislocation fractures: When the ligaments and/or the discs connecting vertebrae are stretched or torn, the bones may become misaligned.
     
  3. Fracture-dislocation fractures: Occur when bone and ligaments break. A spinal fracture may cause irreversible damage such as complete paralysis.

Symptoms of a spinal fracture

Symptoms of a spinal fracture vary depending on the severity and location of the injury, although the primary symptom fluctuates from moderate to severe back pain that worsens with movement. Symptoms include:

  • Back or neck pain.
  • Numbness.
  • Tingling.
  • Weakness.
  • Muscle spasms.
  • Bowel/bladder dysfunction.
  • Paralysis. Loss of movement in the arms or legs. May indicate a spinal cord injury.

What are the causes of a spinal fracture?

A spinal fracture may be caused by:

1. High-energy traumatic injury in the area, for example:

o Road traffic accident.
o Fall.
o Firearm injury.

2. Loss of bone mass, as caused by osteoporosis, for example. Other possible causes of bone mass loss are: cancer, chemotherapy, radiotherapy, hyperthyroidism and long-term use of corticosteroids. With lower bone mass, bone fractures may occur following normal activities, such as bending forward or picking up something.
 

How can it be prevented?

The best way to prevent a spinal fracture is to change your lifestyle and to take responsibility for your own back health. It is also important to bear in mind that the elderly are more susceptible to spinal column injuries, primarily because of falls.
 

What is the treatment?

The traditional (non-surgical) treatment of spinal fractures includes:

• Rest (for a short time as prolonged activity leads to more bone loss)
• Pain medication
• Calcium and vitamin D supplements
• Use of corsets or braces.

These treatments can reduce pain but do not stabilise the fracture or correct the vertebral deformity.

Most fractures are treated with a brace for up to twelve weeks as this helps reduce pain.

In cases where a vertebral fracture does not improve over a number of weeks with medication and the use of brace immobilisation, surgery may be required.

The common minimally invasive surgical procedures are:

Vertebroplasty: This procedure involves either no manipulation or external reduction of the fraction extension.

Kyphoplasty: A surgical device or instruments are placed into the broken vertebra and used to reduce the vertebral body collapse towards its original shape. The void created after removal of the instrument is filled with stabilising material, which, left in place, stabilises the fracture in the improved vertebral shape.

In rare instances, where the patient has significant loss of height, spine fusion surgery may be necessary.

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