CONDITIONS

What Is Spinal Fracture

A spinal fracture is a crack or break in one or more vertebrae, the interlocking bones that make up the spine and surround the spinal cord. Spinal fractures occur when more weight is placed on the vertebrae than the bone is able to support, causing it to crack beneath the pressure.

Though spinal fractures are typically caused by high-impact accidents or collisions, certain underlying health conditions such as osteoporosis can make this type of injury more likely in day-to-day life.  Age also plays a role in spinal fracture—bones can become thinner and more brittle—especially true if one has osteoporosis.

Women are at greater risk of osteoporosis, and according to research, by age 80; approximately 40% will have had a spinal fracture. The spinal fractures that are most common in osteoporosis patients are known as vertebral compression fractures. An estimated 750,000 Americans are affected by vertebral compression fractures each year.

What Causes Spinal Fracture

A spinal fracture occurs when more force is applied to the vertebrae than the bone can support, causing it to crack or break. In healthy adults, spinal fractures are typically the result of high impact, such as that experienced during a car crash, sports injury, or serious fall.

However, certain pre-existing health conditions can make it more likely that you experience spinal fractures in day to day life. osteoporosis, for example, puts individuals at a much higher risk of experiencing spinal fracture. The type of spinal fracture that most commonly affects osteoporosis patients is known as vertebral compression fracture. In these situations, osteoporosis significantly decreases bone density, causing the vertebrae to collapse from even low impact activities, such as walking, sneezing, or standing up.

According to the Mayfield Clinic, the leading causes of spinal fractures are:

  • Car accidents (45%)
  • Falls (20%)
  • Sports (15%)
  • Acts of violence (15%)
  • Miscellaneous activities (5%)

Risk Factors For Spinal Fracture

The following risk factors can increase the likelihood of a spinal fracture:

  • Age. 80% of spinal fractures occur in patients aged 18-25 years old, most commonly due to injury following participation in high-risk activities like football, hockey, diving, and gymnastics. The risk of spinal fracture also increases for patients over the age of 50, who are at a higher risk of developing osteoporosis, a disease that decreases bone density and increases the likelihood of vertebral compression fractures.
  • Sex. Women are much more likely than men to have low bone density (8 out of 10 osteoporosis patients are women,) and are therefore at greater risk of bone-density related spinal fractures. But men are 4 times as likely to have a spinal fracture due to trauma.
  • Engagement in certain activities such as football, hockey, high-speed driving, and extreme sports.
  • Previous spinal fractures. Individuals who have had previous spinal fractures are at a much higher risk of developing another.

Diagnosing Spinal Fracture

The following tools may be used by your doctor before arriving at a spinal fracture diagnosis:

  • Imaging techniques to visualize the fracture, such as:
    • X-Ray, which utilizes x-rays to produce images of the bone
    • MRI, which utilizes magnetic frequencies to produce three-dimensional images of the bone and body matter surrounding it.
    • CT/CAT scan, which combines x-ray and computational technologies to produce a detailed image of the body structures.
    • Dual-energy x-ray absorptiometry (DXA/DEXA), in which x-rays are used to determine bone density, and therefore the prevalence of osteoporosis
  • Medical history and physical exam to determine your current state of health, and locate and examine the area of pain, while checking for any other symptoms.

Symptoms of Spinal Fracture

The following symptoms may be the signs of spinal fractures:

  • Back pain (sudden onset)
  • Back pain that is lessened by lying down
  • Decrease in spinal mobility
  • Height loss/forward curve to spine (increased forward curvature in the spine is known as kyphosis)

Prognosis

Spinal fractures can most often be healed by 6-8 weeks of rest, which may or may not include the use of pain medications, back braces, and physical therapy. Cases of spinal fractures that do not heal within 6-8 weeks of rest may require surgical intervention.

Living With Spinal Fracture

The following tips can help make living with spinal fracture easier:

  • Seek treatment for underlying conditions. If your spinal fracture is caused by an underlying condition, such as osteoporosis, seek treatment for that condition to hasten your recovery and lessen your risk of developing another fracture.
  • Don’t push yourself beyond your limits. Decreased mobility during recovery can be frustrating, but returning to full activity too soon can actually slow your overall recovery and increase your risk of re-injury.
  • Take your doctor’s recommendations seriously, unless you have considerable evidence to suggest otherwise. Sometimes you may think that you have recovered more fully than you actually have.
  • Be smart about pain management. Talk to your doctor about which method is right to you, and be honest in asking questions about addictions.

Screening

No screening is conducted for spinal fractures. However, if you are a patient over the age of 50, you may want to undergo testing for osteoporosis (a large risk factor for spinal fracture) at the recommendation of your physician.

Prevention

Many cases of spinal fracture, such as those brought on by acute trauma, are difficult to prevent. However, cases of spinal fracture brought about by osteoporosis may be prevented by monitoring yourself for symptoms of osteoporosis and seeking treatment if and when you see those symptoms arise. Early treatment for osteoporosis is key to preventing the continued loss of bone density.

Medication And Treatment

Most cases of spinal fracture are able to heal with 6-8 weeks of rest. During the rest period, patients will be asked to limit their mobility by remaining in bed, decreasing their activity level, or by using a spine brace. Depending on the severity of the fracture and the comfort level of the patient, doctors may or may not prescribe pain management medications. For more information on specific pain management medications, visit thirdAGE’s Pain Management Condition Center. 

Cases that do not heal within 6-8 weeks of rest period may require surgical intervention. The following are the surgical options available for the treatment of spinal fracture:

  • Kyphoplasty. In this procedure, a small, balloon-like probe is placed into the vertebrae and inflated. As the balloon inflates, the vertebra is returned upright from its previously collapsed position. The space that the balloon fills is then filled with bone cement to assure that the vertebra stays in place. This procedure can be done either under general anesthesia (complete sedation) or local anesthesia (sedation only at/near the site of operation).
  • Vertebroplasty. In this procedure, bone cement is injected directly into the collapsed vertebra, without the use of an inflating probe. Recovery times for both kyphoplasty and vertebroplasty are around 6-8 weeks.
  • Vertebral fusion. In this procedure, vertebrae are fused together to increase their strength and decrease the pressure placed on the spinal nerve. Vertebral fusions may also be accompanied by the use of rods, plates, and screws to stabilize one or more vertebrae. Recovery times for vertebral fusion procedures typically range from one to three months.

Complementary and Alternative Treatment

According to the University of Maryland Medical Center, the following supplements may help to increase bone density and decrease the likelihood of a spinal fracture:

  • Calcium, available in supplement form or found naturally in milk, yogurt, cheese, dark green leafy vegetables (spinach/broccoli), salmon, tofu, and almonds.
  • Vitamin D, which aids the body in vitamin absorption. Can be taken in supplement form or natural production can be triggered by sun exposure.
  • Zinc, which helps to prevent bone loss.
  • Black cohosh, which contains estrogen-like substances that prevent bone loss.
  • Red clover, which may help slow bone loss in women.

Alternative treatments may also be used to manage pain associated with spinal fractures. Alternative methods of pain management include:

  • Chiropractic adjustments can help to realign the spine following surgery or injury. Be sure to alert your chiropractor of your condition so that he or she can tailor your treatment to your injury.
  • Acupuncture, a form of traditional Chinese medicine in which small needles are inserted into the body to restore the flow of bodily energy and decrease pain.
  • Mind/body techniques such as yoga, tai chi, and meditation which help to strengthen the connection between mind and body and decrease overall levels of pain.
  • Massage. Trauma to the vertebrae can cause the surrounding muscles to tighten and knot, adding to overall pain levels. Massage can help to release the tension surrounding a spine injury and decrease overall pain levels. Be sure to visit a masseuse qualified to treat patients with spinal injuries, and to alert him or her to your condition.

Care Guide

If you are caring for a loved one with a spinal fracture, consider the following tips:

  • Respect new limitations that your loved one may have. Know that his or her mobility may not be the same as it was before the fracture.
  • Be a movement aid. If your loved one is just regaining his or her mobility, do your best to be a source of both physical and emotional support while they regain their footing.
  • Educate yourself on spinal fractures and the available treatments so that you can be an informed companion at medical appointments.
  • Encourage conversation to address feelings and emotions from both you and your loved one. This will help to prevent any tensions from boiling over.

When To Contact A Doctor

Contact a doctor if you experience any of the following:

  • Sudden onset back pain
  • Muscle weakness in back
  • Decrease in spinal mobility
  • Height loss
  • Pain that worsens or improves after a period of rest.
  • Fever, redness, swelling, or other signs of infection following surgical intervention

 

Questions For Your Doctor

To find an orthopaedic surgeon in your area, visit this site.

To find a licensed chiropractor in your area, visit this site.

Questions For A Doctor

You may want to ask your doctor the following questions:

  • What is the extent of my spinal injury?
  •  What is the cause of my spinal injury?
  • What are the available treatment methods?
  • What are the side effects/potential complications?
  • Will I be able to return to my regular activity level?
  • What can I do to speed my recovery?
  • How long will I remain with limited mobility?
  • Can I still drive/commute to work?
  • What alternative methods of treatment are available?