Spinal fractures occur when one or more vertebrae break. They range from mild compression fractures that cause localized pain to severe burst fractures or dislocations that can damage the spinal cord. The location and severity of the fracture determine the symptoms, the risk to neurological function, and the treatment approach.
Spinal fractures can result from high energy trauma (falls, car accidents, sports injuries) or from minimal force in patients with weakened bones due to osteoporosis. Osteoporotic compression fractures are extremely common, affecting an estimated 750,000 people per year in the United States.
Types and Symptoms
Spinal fractures are classified by their mechanism, location, and degree of instability. Symptoms vary widely depending on the type of fracture.
- Sudden, severe back or neck pain after an injury or fall
- Pain that worsens with movement and improves with rest
- Loss of height or progressive kyphosis (hunched posture) from compression fractures
- Numbness, tingling, or weakness in the arms or legs if nerves are compressed
- Difficulty walking or changes in balance
- Bowel or bladder dysfunction (indicates spinal cord involvement, a surgical emergency)
- Pain with minimal activity in patients with osteoporosis
Evaluation and Treatment Planning
Spinal fractures are evaluated with X rays, CT scans (for bony detail), and MRI (to assess the spinal cord, nerves, and soft tissues). CT scan is the most accurate test for characterizing the fracture. Treatment depends on fracture stability, neurological status, and the patient’s overall health. Stable fractures may be treated with bracing and pain management. Unstable fractures or those with neurological compromise require surgical stabilization.