Spine fractures, also known as vertebral fractures, occur when one or more bones in the spine (vertebrae) break. These fractures can result from trauma, such as falls or car accidents, or from conditions that weaken the bones, such as osteoporosis. Treatment may involve conservative measures or surgery, depending on the severity and location of the fracture.

Types of Spine Fractures

• Compression Fracture: Occurs when the vertebra is compressed or crushed, is common in patients with osteoporosis.
• Burst Fracture: Occurs when the vertebra is severely compressed, resulting in fragments spreading out. Often results from high-energy trauma.
• Flexion-Distraction Fracture: Occurs when the spine is bent too far forward or backward. Commonly seen in car accidents where a seatbelt injury occurs.
• Fracture-Dislocation: Involves both a fracture and a dislocation of the vertebra. Usually results from severe trauma and is highly unstable.

Common Symptoms

• Severe back pain.
• Pain that worsens with movement.
• Numbness, tingling, or weakness in the limbs if nerve damage is involved.
• Loss of height (in cases of compression fractures).
• Deformity, such as a hunched posture.

Cause & Anatomy

• Trauma: Falls, car accidents, sports injuries.
• Osteoporosis: Weakened bones that fracture easily.
• Cancer: Metastatic cancer that spreads to the bones.
• Pathologic Fractures: Fractures due to underlying medical conditions.

Diagnosis

Medical History and Physical Examination:

• Assessment of symptoms, history of trauma, and physical evaluation.

Imaging Tests:

• X-rays to visualize the fracture.
• CT scans for detailed images of bone structure.
• MRI to evaluate soft tissue, spinal cord, and nerve involvement.

Treatment

• Bracing: Wearing a brace to immobilize the spine and allow healing.
• Medications: Pain relievers and anti-inflammatory drugs. Medications to treat underlying osteoporosis if applicable.
• Physical Therapy: Exercises to strengthen the back muscles and improve mobility.
• Activity Modification: Avoiding activities that could worsen the fracture.

Surgical Treatments

Surgery is considered when the fracture is unstable, there’s significant spinal cord or nerve compression, or conservative treatment fails.

Vertebroplasty and Kyphoplasty:

• Minimally invasive procedures where bone cement is injected into the fractured vertebra to stabilize it.
• Kyphoplasty includes the additional step of creating space with a balloon before cement injection.

Spinal Fusion:

• Fusing two or more vertebrae together to stabilize the spine.
• Often involves the use of metal rods, screws, or plates.

Decompression Surgery:

• Removing bone or disc material that is compressing the spinal cord or nerves.

Instrumentation and Stabilization:

• Using metal hardware to stabilize the spine and maintain alignment.

Recovery & Rehabilitation

Immediate Postoperative Care

• Pain Management: Medications to control pain and inflammation.
• Bracing: Wearing a brace to support the spine during initial recovery.
• Physical Therapy: Early mobilization and exercises to improve strength and flexibility.

Rehabilitation

• Physical Therapy: Structured program to restore movement, strength, and function.
• Activity Modification: Gradual return to normal activities, avoiding high-impact or strenuous activities initially.
• Follow-Up Care: Regular visits to monitor healing and progress.

Risks and Complications

• Infection: Risk of infection at the surgical site.
• Bleeding: Risk of excessive bleeding during or after surgery.
• Nerve Damage: Potential for nerve injury during surgery.
• Implant Failure: Risk of metal hardware loosening or breaking.
• Non-Union or Malunion: Failure of the bones to heal properly.

Benefits

• Pain Relief: Significant reduction in pain.
• Improved Stability: Enhanced stability and alignment of the spine.
• Increased Mobility: Improved ability to perform daily activities.
• Prevention of Further Damage: Stabilizing the spine to prevent further injury.

FAQ’s

How long does it take to recover from spine surgery?
Recovery time varies based on the type of surgery and individual factors. Generally, initial recovery may take 6-12 weeks, with full recovery potentially taking several months.

Will I need physical therapy after spine surgery?
Yes, physical therapy is crucial for regaining strength, flexibility, and function.

Are there any activities I should avoid after spine surgery?
High-impact activities, heavy lifting, and activities that involve twisting or bending the spine should be avoided initially. Your surgeon will provide specific guidelines.

How effective is spine surgery for fractures?
Spine surgery can be highly effective in stabilizing the spine, relieving pain, and improving function. Outcomes depend on the severity of the fracture and adherence to postoperative care and rehabilitation.

What can I do to prevent spine fractures?
Maintaining bone health through a diet rich in calcium and vitamin D, regular weight-bearing exercise, avoiding smoking and excessive alcohol, and taking medications to manage osteoporosis if needed.