SPINE FRACTURES

Spine Fractures

Incidence and prevalence consist of two terms used to describe the frequency and prevalence of a disease when the bone or vertebral body in the spine collapses, significant pain, deformity, and loss of height can result. These fractures become more prevalent in the thoracic spine (middle section of the spine), particularly in the lower region. Spinal injuries can vary from minor ligament and muscle strains to bone vertebral fractures and dislocations, as well as disabling spinal cord injuries. The spinal cord can get pinched, compressed, or torn by spinal fractures and dislocations.

Types of Spinal Fractures

Doctors classify different spinal fractures to include compression, rupture, flexion and extension, and fracture displacement. We will discuss each of these types of fractures. Other terms that doctors may use to describe a fracture include stable, unstable, minor, and/or major.

Compression Fracture:

Patients with osteoporosis or those whose bones have been damaged by other conditions suffer from this sort of fracture. The vertebra can only absorb so much pressure; if a sudden force or a great deal of pressure occurs on the spine, a bone may fracture when it cannot sustain the force. Compression fractures can further sub-divide into wedge fractures. Wedge fractures occur when a portion of the vertebra, generally the anterior (front) half, collapses under pressure and forms a wedge shape.

Burst Fracture:

Severe trauma leads to fractures that burst. They occur when strong stresses compress the vertebra. With burst fractures and unlike compression fractures, numerous sections of the vertebra shatter.  Bony fragments can spread out and cause spinal cord damage since the vertebra becomes entirely crushed. Doctors classify compression fractures as less severe than serious burst fractures.

• Flexion-distraction Fractures: You could acquire a flexion-distraction fracture if you’re in an automobile accident when your body gets thrust forward. Your spine flexes forward, but if you suddenly move forward and put a lot of force on it, you might shatter a vertebra or vertebrae. A flexion-distraction fracture typically involves fractures in the posterior and middle columns, according to the three-column paradigm.
• Fracture-dislocation: A fracture-dislocation occurs when one of the above fractures occurs and the vertebra moves considerably. These fractures usually affect all three columns of the three-column concept, making your spine extremely unstable.

Stable and Unstable Fractures

• Stable fractures do not cause Spinal deformity and neurologic (nerve) issues. The spine can still bear and distribute your weight rather effectively with a stable fracture (not as well as it could if there wasn’t a fracture, but it still functions).
• The spine has a hard time carrying and distributing weight when it has unstable fractures. Unstable fractures can get worse and inflict further injury. It’s also possible that they’ll result in spinal deformity.

Major and Minor Fractures

A minor fracture occurs when a portion of the posterior components of the vertebra breaks. The spinous process and the facet joints belong to the posterior parts. If you fracture this section of the spine, it does not cause major issues.

The vertebral body, pedicles, or lamina all shatter in a major fracture. Because it helps carry so much weight and disperses the impact of your movements, doctors will advise that a vertebral body fracture appears as a very serious injury. When shattered, the vertebrae can’t line up properly. The increased risk of nerve injury when the pedicles or lamina get fractured appears severe. Furthermore, the pedicles and lamina give a great deal of support to maintain your spine in place. Your spine can become unstable if they break.

Spine Fracture Causes

Simple daily movements such as stepping out of the shower, sneezing hard, or moving a light object can produce a vertebral compression fracture (VCF). This type of fracture collapses one or more spinal vertebrae because of bone compression in persons with severe osteoporosis (weak, brittle bones). Increased force or stress, such as falling or attempting to move a large object can generally produce a VCF in patients with mild osteoporosis. VCFs appear as the most prevalent kind of fracture in osteoporosis sufferers, impacting around 750,000 people each year. In the United States, VCFs affect around a quarter of all postmenopausal women. This ailment becomes more common as individuals become older, with an estimated 40% of women in their eighties and nineties suffering from it.

VCFs are a serious health risk for elderly males while being significantly more frequent in women. People who have had one osteoporotic VCF are five times more likely to have another. A VCF might sometimes only have moderate symptoms or no symptoms at all, but there exists a danger of more VCFs developing. A VCF usually occurs because of significant trauma, such as a vehicle accident, sports injury, or a hard fall, in people with healthy spines. Doctors look at metastatic cancer as a possible cause for people under the age of 55 who have little or no trauma. Many cancers have been reported to spread via the bones of the spine. When this happens, parts of the vertebra may become destroyed by cancer, weakening the bone until it falls.

Spine Fracture Symptoms

In addition to back pain, spinal compression fractures can result in:

• When you stand or move, the pain grows greater, but when you lie down, it feels better.
• You have difficulty bending or twisting your body.
• Loss of stature
• Your spine has a bent, stooping curvature.

Pain will usually occur by a little back strain during ordinary activities such as:

• Getting a grocery bag off the ground
• bending to pick something up from the floor
• Making a blunder or slipping on a rug
• Getting luggage out of a car’s trunk
• When changing bed sheets, lift the corner of the mattress.

Medical Treatment

Most fractures should heal when attached to an orthotic device for up to 12 weeks. Bracing helps to relieve pain and avoid deformities. To prevent additional injury, pain control and stability should be the first steps in treating a fracture. Other injuries to the body, such as those to the chest, may occur and require care as well. Bracing and/or surgery may help, but it depends on the kind of fracture and how it affects the body’s stability.

Surgical Spine Fracture Treatment

Doctors will recommend Surgery in severe situations: Vertebroplasty, a relatively recent surgical treatment, works well when treating compression fractures. A catheter gets inserted into the compressed vertebra by the surgeon in this technique. The shattered vertebrae get injected with bone cement, which hardens and stabilizes the vertebral column. This method minimizes or eliminates fracture pain, allowing for a quick return to movement while also reducing bone loss from bed rest. It does not, however, repair a spinal abnormality. Under X-ray guidance, a tube gets inserted into the spinal column, followed by the insertion of an inflatable bone tamp.

The surgeon cuts the back with a slight incision. When the tamp gets inflated, it raises the vertebral body to its original height and creates a cavity for bone cement to fill. The cement protects the vertebra from collapsing by sealing fractures and holes. The tube gets withdrawn and the incision gets stitched upon the cavity being filled. The Cleveland Clinic has demonstrated the efficacy of kyphoplasty on hundreds of patients. Surgeons can stabilize broken vertebrae by removing them and replacing them with a plate, screws, or a cage.

Spinal Fracture Prevention

Preventing trauma-induced spinal fractures appears as an insurmountable endeavor.  While certain circumstances cannot be avoided, preventative measures can protect you from serious injury.  The following addresses some of those methods.

Driving

When driving, always buckle up. Seat belts and airbags will protect you in the event of an accident, particularly your head, neck, and chest. You should adjust your seat such that you have 10 inches between you and the airbag to obtain the most protection from the seat belt and airbag. This will allow it to deploy without inflicting any further damage.

Falls

A little fall might shatter a bone if your bones have been weakened by osteoporosis or another ailment (e.g., cancer).

Sports

Always utilize safety equipment when engaging in any sport as spinal fractures can occur.

Outcomes

After a fracture heals, the patient should participate in rehabilitation, regardless of whether surgical or nonsurgical.

Rehabilitation Goals Achieve the Following:

• Reducing pain
• Restoring mobility
• Returning the patient to his or her pre-injury state as precisely as feasible
• To assist you attain these goals, your doctor may suggest both inpatient and outpatient physical therapy.

If you have an osteoporosis-related fracture, you’re more likely to have another one. Your doctor will suggest techniques to address bone density loss during your treatment and recovery. Complications, whether large or small can delay or impede rehabilitation and recovery in some circumstances. Inadequate fracture reduction, neurologic damage (paralysis), and increasing spine deformity worry doctors when they see patients in the hospital for the first time.