SPINAL FRACTURES

What is a Compression Fracture?

As we age, Osteoporosis can cause the bones to thin and makes them more susceptible to fractures. Fractures caused by osteoporosis most often occur in the spine. If put under enough stress, the bones of the spinal vertebrae may compress and start to crack, causing intense pain, loss of strength, and in extreme cases, loss of feeling.

Causes of Spinal Fractures

The most common causes of Spinal Fractures include sports injuries and related trauma, usually stemming from a specific traumatic impact. Vehicular accidents also contribute highly to rates of Spinal Fracture for this reason. The bones in human body also weaken with age, patients with osteoporosis can even experience spinal fractures from everyday activities or falling down.

Who Is At Risk For a Compression Fracture?

Spinal compression fractures mainly affect the elderly population, with an estimated 1.5 million spinal compression fractures annually in the general U.S population. The occurrence of this condition increases with age, reaching 40% by age 80. Postmenopausal women possess a greater risk of getting a compression fracture due to hormonal changes that can lead to weakened bones. Men older than age 65 years also have an increased risk of compression fractures although the risk is remarkably less than that of women of the same age.

Irrespective of bone density, having 1 or more spinal compression fractures leads to a 5-fold increase in the patient’s risk of developing another compression fracture in the future (Lindsay et al).

Spinal Fracture

What Are The Symptoms of a Compression Fracture?

Small compression fractures may not cause immediate symptoms, and only make themselves known through an X-ray. More severe compression fracture will cause symptoms such as:

  • Sudden onset of back pain
  • Eventual height loss 
  • Possible disability
  • Hunched posture
  • Decreased flexibility in the spine

Types of Compression Fractures

A vertebral compression fracture will most commonly occur in the lower back, or “lumbar” spine, and cause pain that gets worse the more patients move, particularly when changing positions. Neurosurgeons typically sort Spinal Fractures into 3 different categories:

Wedge Fractures: The most common form of Spinal Fracture. It occurs when the front of the vertebra collapses but the back of the vertebra remains intact. While usually less painful, Wedge Fractures may lead to deformities such as a hunchback, also known as Kyphosis.

Crush Fractures: Occurs when the entire vertebrae cracks and collapses front-to-back. This fracture causes more pain than a wedge fracture, and can add pressure onto the spinal nerve.

Burst Fracture: The most severe form of Spinal Fracture. Similar to a Crush Fracture, but with pieces of the shattered bone pushing outward into the surrounding tissue. This fracture causes intense pain and patients may experience loss of feeling in the legs, or even lose control of their bladders or bowels. Neurosurgeons urge patients to seek immediate medical attention.

How Do Spinal Specialists Diagnose Compression Fractures?

A spinal specialist will carry out an initial physical examination to determine the cause of a back pain and narrow down the possible problems. Tenderness and sensitivity near specific vertebra along the spine will point to a spinal compression fracture and an x-ray will confirm the condition.

The specialist may conduct a neurologic exam to test the muscle and reflex strength of the patient in order to determine whether the fracture has compressed a nerve in the case where the patient experiences pain that extends to the legs.

The specialist may order a CT scan to observe whether or not the fractured bones remained stable. This scan generally provides the specialist with more information than a basic x-ray.

A spinal specialist could also perform an MRI scan if the specialist suspects that the patient’s pain comes from another condition. An MRI scan displays a higher level of detail of the soft tissues surrounding the affected vertebra. The MRI scan could also tell if the fracture already existed or not.

The age of the fracture can help to guide subsequent treatment options. A nuclear bone scan may prove useful to determine the age of the fracture.

Underlying medical conditions such as bone cancer may cause spinal compression fractures and the patient may take a biopsy to detect this condition.

How Can A Compression Fracture Be Prevented?

Natural methods of reducing the risk of a compression fracture include taking calcium supplements, quitting smoking, preventing falls, doing strength-building exercises, eating a healthy diet, getting enough vitamin D and going for regular health checkups .

How Do Neurosurgeons Treat a Spinal Fracture?

Conservative Treatments for Spinal Fractures

Physicians will first examine the patient to determine the severity of the fracture. Patients may receive X Rays, MRI scans or CT scans to pinpoint the damaged vertebra. If a Neurosurgeon determines that they can deal with a spinal fracture conservatively, they may prescribe limited pain medication and that the patient rest for 6 – 8 weeks in order to heal. If physicians determine Osteoporosis as a contributing factor to the injury, they may also treat patients for bone density loss.

Surgical Treatment for Spinal Fractures

If Neurosurgeons determine a Spinal Fracture serious enough for surgical intervention, patients may consider undergoing a Kyphoplasty, or Vertebroplasty. Both non-invasive, these surgeries involve inserting a needle into the fractured vertebra and injecting the injured area with a special bone-cement. This cement fills the cracks of the bone, strengthening the vertebra once again.

Recovery From Spinal Fracture Surgery

Kyphoplasty usually does not require stitches, and patients may sometimes even leave the hospital as little as 1 hour after waking up from surgery. As a procedure with a track record of good patient outcomes, patients who receive a Kyphoplasty return to their daily activities extremely quickly.

If You Think You May Be Suffering From A Spinal Fracture and require a Fort Worth Brain and Spine Specialist, Contact Longhorn Brain & Spine Immediately To Get a Consultation.

References

  1. Lindsay R, Silverman SL, Cooper C, et al. Risk of new vertebral fracture in the year following a fracture. JAMA. 2001 Jan 17;285(3):320–3. DOI: http://dx.doi.org/10.1001/jama.285.3.320. 
  2. . Kim DH, Vaccaro AR. Osteoporotic compression fractures of the spine; current options and considerations for treatment. Spine J. 2006 Sep–Oct;6(5):479–87. DOI: http://dx.doi.org/10.1016/j.spinee.2006.04.013.