A vertebral fracture is a break in one of the bones that make up the spine (vertebrae). The vertebrae are stacked on top of each other to form the spinal column. They support the body and protect the spinal cord. The vertebral column has an upper part (cervical spine), a middle part (thoracic spine), and a lower part (lumbar spine). Most vertebral fractures occur in the thoracic spine or lumbar spine.
There are three main types of vertebral fractures:
- Flexion fracture. This happens when vertebrae collapse. Vertebrae can collapse:
- In the front (compression fracture). This type of fracture is common in people who have a condition that causes their bones to be weak and brittle (osteoporosis). The fracture can make a person lose height.
- In the front and back (axial burst fracture).
- Extension fracture. This happens when an external force pulls apart the vertebrae.
- Rotation fracture. This happens when the spine bends extremely in one direction. This type can cause a piece of a vertebra to break off (transverse process fracture) or move out of its normal position (fracture dislocation). This type of fracture has a high risk for spinal cord injury.
Vertebral fractures can range from mild to very severe. The most severe types are those that cause the broken bones to move out of place (unstable) and those that injure or press on the spinal cord.
This condition is usually caused by a forceful injury. This type of injury commonly results from:
- Car accidents.
- Falling or jumping from a great height.
- Collisions in contact sports.
- Violent acts, such as an assault or a gunshot wound.
This injury is more likely to happen to people who:
- Have osteoporosis.
- Participate in contact sports.
- Are in situations that could result in falls or other violent injuries.
Symptoms of this injury depend on the location and the type of fracture. The most common symptom is back pain that gets worse with movement. You may also have trouble standing or walking. If a fracture has damaged your spinal cord or is pressing on it, you may also have:
- Loss of movement.
- Loss of bowel or bladder control.
This injury may be diagnosed based on symptoms, medical history, and a physical exam. You may also have imaging tests to confirm the diagnosis. These may include:
- Spine X-ray.
- CT scan.
Treatment for this injury depends on the type of fracture. If your fracture is stable and does not affect your spinal cord, it may heal with nonsurgical treatment, such as:
- Taking pain medicine.
- Wearing a cast or a brace.
- Doing physical therapy exercises.
If your vertebral fracture is unstable or it affects your spinal cord, you may need surgical treatment, such as:
- This procedure involves removing the part of a vertebra that is pushing on the spinal cord (spinal decompression surgery). Bone fragments may also be removed.
- Spinal fusion. This procedure is used to stabilize an unstable fracture. Vertebrae may be joined together with a piece of bone from another part of your body (graft) and held in place with rods, plates, or screws.
- In this procedure, bone cement is used to rebuild collapsed vertebrae.
- Take medicines only as directed by your health care provider.
- Do not drive or operate heavy machinery while taking pain medicine.
- If directed, apply ice to the injured area:
- Put ice in a plastic bag.
- Place a towel between your skin and the bag.
- Leave the ice on for 30 minutes every two hours at first. Then apply the ice as needed.
- Wear your neck brace or back brace as directed by your health care provider.
- Do not drink alcohol. Alcohol can interfere with your treatment.
- Keep all follow-up visits as directed by your health care provider. This is important. It can help to prevent permanent injury, disability, and long-lasting (chronic) pain.
- Stay in bed (on bed rest) only as directed by your health care provider. Being on bed rest for too long can make your condition worse.
- Return to your normal activities as directed by your health care provider. Ask what activities are safe for you.
- Do exercises to improve motion and strength in your back (physical therapy), as recommended by your health care provider.
- Exercise regularly as directed by your health care provider.
- You have a fever.
- You develop a cough that makes your pain worse.
- Your pain medicine is not helping.
- Your pain does not get better over time.
- You cannot return to your normal activities as planned or expected.
- Your pain is very bad and it suddenly gets worse.
- You are unable to move any body part (paralysis) that is below the level of your injury.
- You have numbness, tingling, or weakness in any body part that is below the level of your injury.
- You cannot control your bladder or bowels.