Learn about spinal trauma or spinal fractures, their causes, diagnosis, and treatment options, including surgery and non-surgical interventions for patients with vertebral injuries.
Understanding Spinal Trauma
Introduction to Spinal Fractures
Spinal fractures or vertebral fractures usually occur in two different populations of patients. They can occur in an elderly osteoporotic person with very little trauma, or they can occur in a younger person after a more major trauma, like a car accident, falling from a height, skiing accident etc.
Osteoporotic fractures are covered in the osteoporosis section.
The spine is a strong construction and serves as a support of the body so that the standing position can be maintained. The spine also serves as a protector for the nerves for the upper and lower parts of the body. Spinal fracture of one or more of the spinal vertebrae is a dramatic event.
Diagnosis and Causes
Spinal fracture of one or more of the spinal vertebrae is a dramatic event. In an otherwise healthy person, a spinal fracture requires a certain degree of force, and is most often seen in major trauma events. After a spinal injury, the person is usually brought to the hospital in an emergency setting with a great deal of pain in the area where the fracture is located. Frequently, there are other major injuries as well, including a spinal cord injury.
Vertebral fractures can occur in any region of the spine. The most frequently affected regions are the bottom part of the neck (cervical spine) and in the lower back (upper lumbar spine) area. Again, depending on the amount of force involved in the traumatic event, the amount of damage to the vertebrae varies. One can have a major trauma with extensive damages to the vertebrae and spinal cord and nerves, or one can have minor trauma with much less damage to the vertebrae. Fortunately, it is seldom that the spinal cord is damaged where paralysis can occur.
One of the main focuses both for the affected person and the health personnel involved is to assess the severity of the fracture. Some fractures need immediate surgery to protect the spinal cord; other unstable fractures need surgery within1-3 days. Some stable fractures do not need any surgical treatment.
Treatment of Spinal Injuries
Most spinal injuries do not require surgery as the fracture is most often stable. If surgery is needed, the main focus is to prevent the fracture from progressing and causing further damage, either to the spinal cord or to the normal posture of the spine. Fractures of the spine can cause increased rounding of the spine (kyphosis) which can lead to pain and poor function because of the changes in posture. Therefore, most often, the surgical treatment is fixation of by screws and rods, placed over and under the affected vertebrae, thereby preventing further deforming changes in the posture. If surgical treatment is not indicated, a corset or brace is usually applied. The corset works as partly pain reducing, or can reduce the degree of posture changes as the fracture heals.
Initially a spinal fracture is associated with a great deal of pain but this acute pain usually subsides within 4-8 weeks. In spite of surgical treatment, or treatment with a corset, some may experience ongoing pain and posture changes (increased kyphosis) after having a spinal fracture and are recommended to discuss this with their health care team.
EUROSPINE is a society of spine specialists of various disciplines with a large knowledge of spine pathologies. All well-known and accepted treatment modalities for spine pathologies are represented by the members of the society. However, the Society cannot accept any responsibility for the use of the information provided; the user and their health care professionals must retain responsibility for their health care management.