Spine Fracture

A spine fracture is a break in one or more vertebrae, the bones that make up the spinal column. It can follow major trauma, such as a road accident or a fall from a height, or even a minor fall in people whose bones are weakened by osteoporosis, infection or tumour. Some fractures are stable and heal with a brace, while others are unstable or press on the spinal cord and nerves and need surgery.

Symptoms

• Sudden, severe neck or back pain after an injury
• Pain that increases on moving, sitting up, standing or walking
• Tenderness, swelling or a visible step or bend in the spine
• Numbness, tingling or weakness in the arms or legs
• Difficulty controlling the bladder or bowel
• In older people, sudden back pain after a minor fall, lifting or even coughing, or a gradual loss of height and stooping

Causes

• Road traffic accidents
• Falls from rooftops, trees, ladders or stairs
• Osteoporosis, which can lead to compression fractures, especially in elderly people and women after menopause
• Bone weakened by cancer spread or infection

Diagnosis

After an accident, the patient is first stabilised in the emergency department with the spine protected. A full neurological examination checks for any damage to the spinal cord or nerves. X-rays and a CT scan show the pattern of the fracture in detail, while an MRI shows the spinal cord, nerves, ligaments and discs. When a fracture occurs with little or no injury, a bone density test and other investigations are done to find the underlying cause.

Treatment

Stable fractures without nerve injury are usually treated without surgery. This involves pain relief, a brace or neck collar for a period of weeks, gradual return to walking, physiotherapy and follow-up X-rays to confirm healing. In osteoporotic fractures, treating the weak bones is just as important to reduce the risk of further fractures.

Surgery is advised when the fracture is unstable, when the spinal cord or nerves are compressed, when deformity is increasing, or when pain cannot be controlled. The operation aims to relieve pressure on the nerves (decompression), restore alignment and hold the spine firmly with screws and rods while the bone heals. In suitable cases, minimally invasive fixation through small skin incisions is possible, which reduces muscle damage. For painful osteoporotic compression fractures that do not settle, injecting bone cement into the vertebra (vertebroplasty or kyphoplasty) may be considered.

When to Seek Urgent Care

Go to the nearest emergency immediately after any of the following:

• A significant fall or accident followed by neck or back pain
• Weakness, numbness or tingling in the limbs after an injury
• Loss of bladder or bowel control
• Difficulty breathing after a neck injury
• An unconscious person after an accident, who should be treated as having a spine injury

If a spine injury is suspected, do not move the person's neck or back or try to sit them up. Keep them still and call an ambulance (108 or 112). Move them only if they are in immediate danger, keeping the head, neck and body in line.

If you have had a spine fracture or ongoing back pain after an injury, you are welcome to consult Dr. Prashant Sharma at Keshav Super Speciality Hospital, Meerut, for assessment and advice.

Related Conditions

• Spinal Tuberculosis (Pott's Spine)
• Sciatica
• Back Pain (Backache)
• Neck Pain
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