What is a fractured spine?

A fractured spine is the medical term for breaking any vertebrae: the 33 bones that comprise your spinal column. One bone in your spine is called a vertebra- a vertebrae in the plural form.

Some people refer to a spinal fracture as a broken back. Osteoporosis and traumas such as falls, sports injuries, or car accidents most commonly cause fractured vertebrae.

Most of the spinal fractures will not need surgical interventions, but you will have to wear a brace for several months. The severe spinal fractures will be operated upon. 

What are the symptoms of a spinal fracture?

For many, you don't know at all that you have a compression fracture. This is more true if your broken vertebrae occurred over time from osteoporosis rather than after a trauma. You may feel no pain and only discover you have had a compression fracture when you undergo imaging studies to diagnose or identify other future conditions.

Traumas typically produce burst fractures and Chance fractures. When you undergo trauma, such as a fall or car accident, your fractured back will be diagnosed as part of your treatment for your injuries. You may not feel any specific symptoms from the fracture, mainly when being treated in the emergency room.

If you are symptomatic, you will note the following:

• Back pain: A sharp, stabbing pain in your back. Pain may also get more severe, especially if you walk or move about.
• Swelling or tenderness: Swelling and pain on the side of the broken vertebrae.
• Change in posture: Lymphoma could also cause an inappropriate curvature of the spine. You may develop a new slump or stoop that makes you bend forward in new ways.
• Numbness or tingling: A feeling of tingling or numbness in your back that can radiate down to your arms or legs.
• Loss of height: You can also become severely shorter over time (sometimes by as much as 6 inches).
• Loss of bladder and bowel control: A loss of ability to control your bladder or bowels that has developed recently.

What causes broken backbones?

Causes of broken spine:

• Osteoporosis: Osteoporosis makes your bones weaker and more porous. This increased fragility leaves you at much higher risk for any type of fractures.
• Trauma: Traumas generate highly stressful force on your bones. Your spine is usually very flexible and with you in constant motion. However, the extreme force of a car accident or sporting injury can create a force greater than your spine can accept, resulting in spinal fractures.
• Spinal tumors: Most spinal tumors are caused by metastasis of cancer — cancer that has spread from another area of your body to your spine.

How are spinal fractures diagnosed?

Spinal fracture diagnosis: Your doctor is going to perform a physical examination along with imaging tests to diagnose a spinal fracture. Your doctor is going to examine your back. The doctor will check if there are any spots that are tender or painful to touch, as well as changes in the curvature of your spine and posture. It is essential that you inform them of the places where you are experiencing pain and when the new pains started.

If you experience a trauma, the fracture might be recognized by the emergency room providers. They will identify your fracture and any other injuries after you have been stabilized.

What tests are performed to diagnose a compression fracture?

Following a physical examination, you will likely require at least one of several imaging studies to obtain pictures of your spine:

• X-rays: A back X-ray will confirm whether your spine is indeed fractured. This will also show how your bones are displaced.
• Magnetic Resonance Imaging (MRI): the doctor may need an MRI of your back and what can have been damaged internally. This will highlight soft tissues around your spine, including vertebrae. Be sure to bear this in mind, especially if the doctor feels that you have a potential risk for damage to your spinal cord with the fracture of your spine.
• CT scan: If you're going to have surgery, your doctor or surgeon needs to know precisely just how much your bones are damaged. A CT scan gives them a much better picture of your bones and the tissue immediately around the bones than an X-ray.
• You may need a bone-density test, also known as a DEXA or DXA scan. This will diagnose osteoporosis and determine the extent to which your bones have been weakened.

What is the treatment for your fractured spine?

Your treatment will depend on several factors, such as:

• What caused the fracture?
• What type of fracture do you have?
• Where the broken vertebrae are located in your back.

Most spinal fractures don't need surgery. The majority of treatments involve:

• Bracing: You may need to support your spine with a back brace to keep it in place while the broken vertebrae heal. Most people must wear a brace for several months. Your doctor will discuss which type of brace you will require and how long you have to wear it.
• Physiotherapy: Exercises to strengthen the muscles of your back, strengthen your overall body, reduce bone loss, and hence lower the chances of further spinal fractures. Sometimes, this may have to be done in the presence of a physical therapist, or you may also do exercises at home.
• Treatments for osteoporosis: If you are suffering from osteoporosis, your provider is likely to prescribe you medicine or even over-the-counter supplements to help strengthen your bones and prevent future fractures.

If you are traumatized, the doctors in the emergency room will address your injuries based on how severe they are, especially if a few of them could prove fatal for you.

Spinal fracture surgery

If you may have a spinal fracture that could risk your spinal cord or your pain does not disappear after some months while using nonsurgical treatments, then you may undergo surgery. Vertebroplasty and kyphoplasty are the two most used surgical techniques for corrective spine correction.

• Vertebroplasty: Your surgeon will insert liquid cement into your fractured vertebrae to strengthen them.
• Kyphoplasty: This is very similar to the procedure for vertebroplasty, except that before your surgeon injects the liquid cement into your vertebrae, they first insert a small balloon inside them. Once inflated, this will push the bones back into their proper place and re-create the space originally there before your fracture.

Most are outpatient procedures, so you should be able to leave the hospital the same day. You should spend up to 24 hours in bed before returning to your routine. Do not do heavy lifting or intense exercise for at least six weeks after surgery.

Your surgeon or provider will describe the surgery you require and why. If your spinal fracture was a result of a tumor — either benign or cancerous — you might need other or additional procedures to remove the mass before your spine may be treated.

What medications are used to treat spinal fractures?

Generally, over-the-counter NSAIDs will be sufficient to control the symptoms of a spinal fracture. Talk to your doctor or surgeon before you continue to use NSAIDs for longer than ten consecutive days.

Medications for osteoporosis:

If osteoporosis is the cause of the spinal fracture, osteoporosis medications to strengthen your bones may be started, including:

• Calcitonin salmon: Calcitonin salmon is an artificial hormone inhaled as a nasal spray. It may reduce pain and your risk of having additional spinal fractures.
• Calcium supplements: You may need to start or continue calcium supplement therapy to strengthen your general bone health and lessen the risk of future fractures.

Your physician will refer you to a bone doctor for future follow-ups and treatments of your bones.

What are the side effects of the treatment?

The side effects of NSAIDs are:

• Bleeding.
• Ulcers.
• Stomach pain.
• Bowel complications.

Calcitonin salmon have severe adverse effects, which include:

• Epistaxis
• Pain in the sinuses.
• Shortness of breath.
• Trouble swallowing.
• Lump formation or swelling in the tongue or throat.

How long before treatment will I feel better?

Most patients start feeling better a few weeks after beginning treatment.

Healing time is different for every individual vertebrae depending on the type of fracture, which of your vertebrae were broken, and any other injuries you experienced.

How can I prevent a spinal fracture?

For general safety tips to lower the risk of an injury:

• Seatbelt: Wear a seatbelt at all times. This includes the shoulder harness that is around your upper half.
• Sporting gear and exercise: Use proper protective gear for any sporting activity and exercise.
• Household and workplace: Make sure your home and working environments remain free from clutter that may lead to tripping, either for yourself or anyone else.
• Household equipment: Always use the correct tools or equipment to access things in your home. Stay on chairs, tables, or countertops.
• Stay on a diet and an exercise program to keep your bones healthy.
• If you are over 50 or have a family history of osteoporosis, talk with your provider about getting a bone density test.
• Use your cane or walker if you can't walk well or are at increased risk for falls.
• A healthy diet and regular exercises will prevent the outbreak of osteoporosis. A diet rich in calcium and vitamins C and D stimulates bone growth and strength. Those exercises that make your muscles work against gravity strengthen your bones-such as walking, jogging, aerobics, and lifting weights.

What will happen to me if I have a fractured spine?

Provided that your spinal cord is intact with no breakage, nerves, or other tissue around your spinal column, you are not expected to incur any long-term effects resulting from a spinal fracture. If you were diagnosed with osteoporosis when you had a spinal fracture, then you should always go for regular bone density screening to monitor the process of your bones.

If the fracture or other injuries damaged your spinal cord, you may be permanently disabled from moving or walking. These complications can occur with most traumatic injuries, particularly unstable burst fractures or Chance fractures.

Living With

What can I do to take care of myself?

Discuss a diet and exercise program with your provider to help you maintain healthy bones.

One in four women and people assigned female at birth who have a compression fracture due to osteoporosis never even have it diagnosed, even if they are only minimally symptomatic. Discuss new back pain or discomfort with your provider. They can guide you in determining what is causing it and, perhaps, catch osteoporosis or another medical condition before causing severe symptoms or fractures.

To seek an expert consultation for any orthopedic condition.

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