A vertebral fracture is understood to mean the fracture of a vertebra. The vertebral body, the vertebral arch or the spinous process are affected.
What is vertebral fracture?
A vertebral fracture occurs when a part of the vertebra breaks. These include the vertebral arch, the vertebral body or the spinous process. Vertebral fractures are usually the result of a minor accident. However, they can also occur spontaneously as a result of an illness. These primarily include pronounced bone loss ( osteoporosis ) or tumor metastases in the spinal column area. For definitions of hospitalism, please visit topbbacolleges.com.
Vertebral fractures are most common in the lumbar spine (LWS) and thoracic spine (thoracic spine). In Germany alone, around 6,000 vertebral fractures occur every year. In the worst case scenario, severe spinal injuries can even lead to permanent paralysis.
The causes of vertebral fractures are different. In young people, they often occur as a result of traffic accidents, accidents at work, accidents in the home, falls, sports injuries such as skiing or horseback riding, or after physical violence. However, vertebral fractures are also possible in senior citizens without any specific external influence, because their bone structure is already suffering from previous damage.
Osteoporosis is the most common reason for a disease-related vertebral fracture. But other pathological causes such as osteitis (bone inflammation), softening of the bones ( osteomalacia ), rheumatism, bone cancer or metastases in the skeleton can also be triggers. The vertebral fracture begins without a recognizable cause such as an accident. Everyday stress already leads to a fracture of the vertebra, because the bone can be subjected to significantly less stress due to the disease.
Symptoms, Ailments & Signs
A typical symptom of a vertebral fracture is back pain that starts suddenly. Even at rest, the pain is more or less pronounced. The symptoms usually get worse when you move. If there is a fracture in the cervical vertebrae, the patient is no longer able to move his head properly. Because of this, he keeps him in a forced posture.
Other possible indications of a vertebral fracture are abrasions, a hematoma (bruise) and deformities. Sometimes the spinous processes at the fracture point are at a greater distance from each other than usual. If the nerves or the spinal cord are also affected by the vertebral fracture, further symptoms appear. This can be muscle weakness, muscle paralysis, numbness or incontinence. Paraplegia is also a possibility.
A rapid loss of height in the affected person is an indication of a vertebral fracture caused by osteoporosis. The patient loses several centimeters in size.
Diagnosis & course of disease
If there is a suspicion of a vertebral fracture, the doctor first looks at the patient’s medical history and has the accident that caused it described in detail. The symptoms and the type of injuries can also provide important information about the condition of the person concerned. A possible indication of a vertebral fracture is pressure or percussion pain in a certain section of the spine.
After a physical examination, the nerve functions are assessed. X-rays are also taken to confirm the diagnosis. To diagnose a vertebral fracture, x-rays can be taken at multiple locations in the spine. Instabilities can be detected with this method. If the patient suffers from unconsciousness, the entire spine must be subjected to an X-ray.
If the X-ray examination actually reveals a vertebral fracture, a computer tomography (CT) is then carried out to determine the damage to other body structures such as the spinal cord canal. The course of a vertebral fracture depends on its extent. This means that certain misalignments cannot always be prevented. Symptoms of overuse are also possible, but these do not always result in pain. If osteoporosis is present, there is a risk of further vertebral fractures.
As a rule, there are good chances of recovery in the event of a vertebral fracture. However, in some cases, complications can also arise, sometimes with serious consequences. This is especially the case when nerve tissue is injured. Sometimes there is also narrowing of the spinal canal.
Neighboring segments can also be degenerated. Complications also depend on the type of vertebral fracture. There are stable and unstable vertebral fractures. A stable vertebral fracture is characterized by undamaged soft tissue and ligaments surrounding the fracture. There are no neurological disorders here. In unstable vertebral fractures, entire vertebral sections are deformed.
There is a great risk here that displaced bone fragments will injure the spinal cord. In extreme cases, the unstable vertebral fracture can even cause paraplegia. In addition to spinal cord injury, post-traumatic kyphosis or post-traumatic scoliosis can also occur as long-term consequences of a vertebral fracture.
When the vertebrae collapse forward, a so-called widow’s hump occurs, which is also known as kyphosis. Scoliosis (lateral curvature of the spine) is caused by lowering of the lateral edges. This puts additional strain on the intervertebral discs in this area. Spinal deformities can also be associated with restricted mobility and pain.
When should you go to the doctor?
It is necessary to see a doctor as soon as pain occurs in the back area or mobility restrictions appear after an accident, a fall or a violent impact. If the back can no longer be moved as usual, there is a need for action. Numbness, sensory disturbances and a sudden loss of physical performance indicate a health problem. Since serious cases can lead to lifelong impairments, a doctor should be consulted as soon as possible. If incontinence occurs, this is to be interpreted as a warning signal from the organism.
If the person concerned can no longer move around without help and takes on a forced posture of the body, a doctor is needed. In particularly acute cases, an emergency service must be alerted. Until it arrives, first aid measures must be taken and the instructions of the emergency medical team must be followed. To avoid complications, it is important that no jerky movements are performed. A vertebral fracture is characterized by pain and discomfort that also occurs at rest. Even minor movements can lead to intense attacks of pain. If the head or limbs cannot be moved at all or only to a limited extent, this is also a cause for concern and should prompt a visit to the doctor.
Treatment & Therapy
A vertebral fracture can be treated both conservatively and surgically. If the fracture was caused by an accident, the fracture is first stabilized to counteract further damage to the vertebra or spinal cord.
If there is no risk of instability, conservative therapy takes place. The patient has to stay in bed for a few days. Pain is treated with analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) or calcitonin. Supported by the application of a chest corset and with the help of a physiotherapist, the patient can usually get up again after a short time. Special exercises are also carried out to train the back muscles.
In addition, the patients learn behaviors that have a positive effect on the back and are similar to a back school. While the first part of the treatment takes place in the hospital, the rest of the treatment takes place on an outpatient basis after two to four weeks. In the case of a cervical fracture, the patient must wear a so-called neck collar (cervical brace) for about 6 to 12 weeks. If an underlying disease such as osteoporosis is responsible for the vertebral fracture, it is also treated.
If the fracture is stable, surgery is only performed if the pain is severe. The situation is different when there is an unstable fracture. In such cases, immediate surgical intervention is necessary. The unstable bone segments are bridged by the doctor with metal screws or rods. In addition, narrowing of the spinal canal is corrected. Additional corset therapy is usually not necessary. After about 6 to 9 months, the stiffened segments have healed.
In many cases, a vertebral fracture can be prevented. It is important to avoid accidents. Traffic safety measures such as back protectors or seat belts can be used for this purpose. In the case of osteoporosis, early therapy is recommended.
Follow-up care plays an important role after the actual treatment of a vertebral fracture. It helps to achieve freedom from pain and optimal mobility of the affected vertebrae. If the vertebral fracture was treated surgically, one of the most important aftercare measures is restoring the stability of the spine. Follow-up treatment takes place as quickly as possible and includes physiotherapy and occupational therapy.
It is not uncommon for follow-up care to begin on the first day after the surgical procedure. Because only small skin incisions are usually made on the spine, no special care is required for the wound. During physiotherapy, the patient exercises specific and slow movements. However, care must be taken to determine whether the vertebral fracture resulted in neurological deficits.
If the operation restores the stability of the spine, the patient undergoes rehabilitation. Its purpose is to enable you to return to work. It is determined whether it is still possible to carry out the previous work activity. Professions that involve heavy physical strain are often seen as an obstacle. In most cases, those affected can return to their usual activities after eight to twelve weeks.
In some cases there is paralysis due to the vertebral fracture. The follow-up treatment should then ensure that the patient’s independence is restored. If a wheelchair is necessary, this usually requires lifelong follow-up care.
You can do that yourself
In the case of a vertebral fracture, the organism must be protected to a sufficient extent. Physical stress and any form of overexertion should be avoided as a matter of principle. In most cases, sporting activities should be avoided during the recovery process or only carried out in a reduced form.
In order not to take any risks or trigger secondary diseases, it should be agreed in cooperation with the treating doctor which types of sports may be carried out. At the same time, it must be checked to what extent professional activities can take place during the healing process or whether sick leave is necessary. The movement sequences should not be jerky in everyday life. Avoid lifting and carrying heavy objects. The fulfillment of daily tasks are to be restructured and should be fulfilled by people from the social environment. At the first physical irregularities or abnormalities, the movements should be slowed down and optimized. In particular, taking one-sided postures should be reduced to a minimum.
The muscles must be protected from hardening. Careful light massages or slow balancing movements help to alleviate the discomfort or prevent pain. Physiotherapeutic measures also support the healing process and can be helpful in preventing further disorders. In addition, the sleeping habits should be optimized and adapted to the current physical possibilities.