Spinal fractures can result from trauma such as road accidents or falls from height, or from minor strain in bones weakened by osteoporosis or tumors. Treatment depends on the fracture type, spinal stability and whether there is nerve injury.
What is a spinal fracture?
Spinal fractures are breaks in the bony structure of the vertebrae. They occur for two main reasons:
- Traumatic fractures: Caused by high-energy injuries such as road accidents, falls from height and sports injuries. They may be accompanied by injury to the spinal cord or nerve roots.
- Osteoporotic fractures: Compression fractures that occur, particularly in older women, when weakened bones collapse after a simple fall, bending or even coughing.
- Pathological fractures: Occur in vertebrae weakened by tumor or infection.
The key questions in treatment are whether the spine remains stable and whether the spinal cord or nerves are compressed.
Symptoms
- Sudden severe back pain at the fracture site
- Pain that worsens with movement
- Numbness or weakness in the arms or legs
- Impaired bladder or bowel control
- Loss of height and a stooped back with osteoporotic fractures
Important: If a spinal injury is suspected after a serious accident or fall, the person should not be moved unnecessarily and emergency help should be called.
Diagnosis
X-rays, CT and MRI are used together. CT shows the bony details of the fracture, while MRI shows the spinal cord and ligaments and whether the fracture is recent or old. Bone density testing is also performed for osteoporotic fractures.
Treatment Approach
- Non-surgical treatment: Most stable fractures without nerve compression are treated with pain control, a brace and controlled mobilisation.
- Vertebroplasty / kyphoplasty: For painful osteoporotic or tumor-related compression fractures, bone cement is injected into the fractured vertebra through a needle in the skin to strengthen it.
- Surgery: For unstable fractures or when the spinal cord or nerves are compressed, the pressure is relieved and the spine is stabilised with screws and rods. In suitable patients this can be done through small incisions (percutaneously).
- Osteoporosis treatment: Treating bone loss and preventing falls are important to prevent new fractures.