Spinal fractures can result from trauma or bone-weakening conditions like osteoporosis. Stable fractures can heal on their own, but serious ones can damage the spinal cord and require surgery. The spine is made up of 33 vertebrae, with different sections playing different roles. Treatment depends on the location and severity of the break.
Spinal fractures are breaks in the vertebrae or bones of the spine. These fractures can result from trauma or a minor act such as coughing and are often made possible by a previous bone-weakening condition, such as osteoporosis. Stable fractures, or fractures that are likely to hold their shape and position after recovery, can usually heal on their own if the patient is protected and able to rest. More serious spinal fractures, however, can pinch and sometimes tear the spinal cord or the bundle of nerves that run along the spine. These unstable fractures can lead to serious problems such as bowel and bladder complications or paralysis and need to be operated on to realign the bones and prevent any damage to the spinal cord.
The spine is made up of 33 bones called vertebrae that provide support for the entire body. The different sections of the spine play different roles in the mobility and support of the body. These sections, from top to bottom, are called the cervical spine, thoracic spine, lumbar spine, sacrum, and tailbone.
The cervical spine, or the neck region of the spine, starts at the base of the skull and continues down to what is called the thoracic spine. The cervical spine is made up of seven vertebrae labeled C1-C7, with C1 being closest to the skull and C7 being closest to the thoracic spine. Fractures of the cervical spine, more commonly known as a broken neck, are usually caused by blunt force trauma and can cause the patient pain, loss of sensation, paralysis, or death. Symptoms often include pain at the site of the injury, pain in the arms or neck, numbness, and paralysis. The doctor will immobilize the patient to prevent further damage, examine the neck with an X-ray or MRI, and then decide whether or not the patient needs surgery.
The twelve vertebrae of the middle back are collectively called the thoracic spine and are labeled T1-T12. These vertebrae attach to the ribs, making them fairly stable and less susceptible to vertebral fractures such as those in the cervical spine. The most common location for a thoracic spine tear is the thoracolumbar region, where the thoracic and lumbar spine meet. The thoracic spine is, however, the most common site for spinal compression fractures, caused by osteoporosis and metastatic tumors. The high level of blood flow through the thoracic spine promotes metastasis, or aggressive spread, of cancer cells.
The lumbar spine is located in the lower back and is made up of five vertebrae, labeled L1-L5. Some people have six lumbar vertebrae. These are the largest vertebrae and carry most of the body’s weight. Because these bones are so strong and have so much muscle support, severe trauma or advanced weakening of the bones is usually associated with lumbar vertebral fractures. Damage to the lumbar spine can impair the patient’s ability to walk or stand.
The biggest fear with vertebral fractures is spinal cord damage. Spinal fractures below L1-L2, in the sacrum or tailbone, do not result in spinal cord injury. There are nerves traveling to the legs after L1-L2 that can be damaged by such an injury, but the spinal cord tapers around L1-L2.
Treatment for vertebral fractures depends on the location and severity of the break. Minor fractures may only require the patient to rest or wear a brace to immobilize the spine and, in some cases, take medications to manage the pain. When surgery is needed, it is usually done immediately, and the damaged vertebrae are often fused together using rods, screws, or cages. Sometimes steroids are also given to limit the possibility of paralysis.
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