Have you ever heard the story of "broken spine"? We've probably heard it after an accident or a fall from a height. And as we get older, we've probably seen some grandparents bend forward a little, that is, hunchback. Both of these conditions are medically called a 'fractured spine'. Hearing this name can be a bit scary, but don't be afraid. Not all spine fractures are serious. Today, we'll talk about everything, causes, symptoms, and treatments, in a very simple way that you can understand.
What exactly is a fractured spine?
Simply put, our spine is not one long bone. It is like a tower made up of 33 small pieces of bone (which we call 'vertebrae') stacked on top of each other. This tower is what allows us to stand, bend, and turn. So, a fracture or break in one or more of these vertebrae is what we call a fractured spine . People often call this a "broken spine" or "broken back."
The main causes of this are osteoporosis and trauma, such as falls, sports injuries, or car accidents.
The best part is that most of these fractures do not require surgery. You may need to wear a special brace for a few months. However, more severe fractures may require surgery to repair.
What are the types of spinal fractures?
A doctor will classify your broken bone based on several factors. That is, where in the bone the fracture occurred, how the bone broke, and whether the broken bone fragments are out of place (stable or unstable). Let's look at these one by one.
Depending on where the break occurred
Our spine is divided into three main parts. A fracture can occur at any of these parts.
- Cervical spine fracture: This happens in the vertebrae in your neck.
- Thoracic spine fracture: A fracture in the upper spine, which extends from the neck to the end of the ribs.
- Lumbar spine fracture: A fracture in the lower spine that causes back pain in many people.
Depending on how the bone was broken
This is a bit important. There are three types that are most commonly seen.
| Break type | Simply explained |
|---|---|
| Compression Fractures | These are small cracks or breaks in the vertebrae. It's like a sponge shrinking when you squeeze it. The main cause of this is osteoporosis . This weakens the bones and can break even with a small fall. Sometimes, this condition can go on for a long time without any symptoms, causing you to lose a few inches in height or to become hunched over (kyphosis) . |
| Burst Fractures | This happens when there is a sudden, high-force impact on the spine. Imagine someone falling from a tall tree and landing directly on their feet. Then, due to the high pressure on the spine, the vertebrae can break into pieces and explode. This is a bit serious. |
| Chance Fractures | This is like the other side of the Burst Fracture mentioned above. What happens here is that the vertebrae pull apart from each other. The best example of this is car accidents. If you wear only the lap belt of the seat belt and do not wear the lap belt, and the vehicle suddenly crashes, the lower part of your body gets stuck in the belt and the upper part is thrown forward rapidly. Then the spine can be stretched and this kind of fracture can occur. That is why it is very important to wear the seat belt correctly. |
By stability of breaking (Stable vs Unstable)
This is what doctors are most concerned about.
- Stable Fracture: Here the bone is broken, but the pieces are not displaced. They are in the right place. This requires treatment, but surgery is unlikely.
- Unstable Fracture: This is the most serious type of fracture. The broken bone pieces have shifted from where they were. This increases the risk of damage to the spinal cord, which is a very important part of the spine . This type of fracture will definitely require surgery.
Who is most likely to develop this condition?
In fact, anyone can have a broken bone due to an accident. But some people are at greater risk.
- Women and people over 50 are at higher risk.
- If you have osteoporosis , your risk of a spinal fracture (especially a compression fracture) is very high. A person who has had one is about five times more likely to have another.
In addition, people with the following health conditions are also at increased risk:
- Cancer (especially if you are receiving chemotherapy or radiation therapy)
- People who have been using corticosteroids for a long time
- Hyperthyroidism
- Bone infections (Osteomyelitis)
- Kidney disease
- Mental illness related to anorexia (Anorexia Nervosa)
- Vitamin D deficiency
- People who smoke and drink heavily are also at higher risk.
What happens to the body when you break your back? Can you walk?
When you break a bone in your spine, it can be difficult for you to move around normally and do useful work. This can be due to pain.
Often, your doctor will prescribe a special brace to help keep your spine straight. This can be a bit uncomfortable to wear, but it's essential for the broken bone to heal properly.
The most important question is, "Can you walk with a broken spine?" The answer is, yes, most of the time you can. In the case of a compression fracture, especially one caused by osteoporosis, you can walk, but you will feel pain. However, if the fracture damages the spinal cord and causes paralysis, you will not be able to walk.
Even if you have minor symptoms, if your back pain doesn't go away in a few days, if it gets worse, or if it's accompanied by swelling, you should definitely see a doctor. If you have had an accident, you should go straight to the ETU (Emergency Treatment Unit).
What are the symptoms of a spinal fracture?
Surprisingly, some compression fractures do not cause any symptoms. Osteoporosis, in particular, may not cause pain when walking. Some people only discover they have an old fracture in their spine when they have an X-ray for another condition.
However, if symptoms do occur, they may be as shown in the table below.
| Symptom | Description | ||
|---|---|---|---|
| Back pain | A sharp, severe pain that comes on suddenly. Or a pain that gradually increases over time. This pain may increase when walking or standing. | ||
| Swelling or tenderness | The fracture site may be swollen and painful to touch. | ||
| Posture change | Posture change | To bend your back forward in a way that it wasn't before, that is, to become a hunchback. | |
| Numbness or loss of feeling | Tingling or loss of sensation from the back to the arms or legs. This can be a serious symptom. | ||
| Height loss | Over time, multiple vertebrae compression can significantly reduce your height (perhaps up to 6 inches). | ||
| Uncontrolled urination | A condition in which you cannot control your urine or stool for a reason you never had before. This is a very serious emergency. You should go to the hospital immediately. |
How does a doctor find this?
When you go to see a doctor, he or she will first ask you questions and do a physical exam. They will examine your back and look for any tenderness, swelling, or changes in the shape of your back. It is important to give detailed information about where you feel the pain and when it started.
Then, they will order several tests to confirm the diagnosis.
- X-ray examination: This can clearly see if there is a fracture or if bone fragments are displaced.
- MRI scan: This can check for damage to not only the bones of the spine, but also the soft tissues around it, especially the spinal cord.
- CT scan: This helps to get a very clear, detailed picture of the damage to the bones if surgery is needed.
In addition, you will be asked to undergo a bone density test (Bone Density Test or DEXA scan) . This can determine if you have osteoporosis and how severe it is.
What are the treatments for this?
Treatment depends on the cause of your fracture, the type of fracture, and where it is located in your spine.
Non-surgical treatments
The good news is that most of the time, surgery is not necessary. The most common treatments are:
- Bracing: You will be given a special brace to keep your spine straight until the broken bone heals properly. This usually lasts for several months.
- Physical therapy: Special exercises are given to strengthen the muscles around the spine. This can reduce pain and help prevent future fractures.
- Treatment for Osteoporosis: If you have osteoporosis, your doctor may prescribe medications or supplements like calcium to strengthen your bones.
Surgery
If the fracture is at risk of damaging your spinal cord, or if your pain doesn't improve after several months of other treatments, you may need surgery. There are two types of surgery that are most commonly performed.
- Vertebroplasty: In this procedure, the surgeon injects a special liquid cement into the fractured vertebra to strengthen the bone.
- Kyphoplasty: This is similar to the previous one, but before injecting the cement, the surgeon inserts a small balloon into the vertebra and inflates it. This causes the compressed and shrunken bone to be lifted back to its proper height. Only then is the cement injected.
Both of these surgeries are usually done on the same day and you can go home (outpatient procedures). However, you will be advised to rest in bed for about 24 hours after the surgery and to avoid heavy lifting for about 6 weeks.
How to reduce the risk?
A spinal fracture is a serious injury, so we should all try to prevent it.
- Always wear your seat belt properly when riding in vehicles. Both the lap belt and the shoulder belt are mandatory.
- Wear the necessary safety equipment when playing sports.
- Don't place things in a way that could cause you to slip and fall at home or at work. Keep things neat and tidy.
- Do not climb on chairs or tables to reach anything above. Use a suitable ladder.
- Maintain a bone-healthy diet and exercise routine. Eat foods rich in calcium, vitamins C, and D. Exercises like walking, jogging, and weight lifting strengthen bones.
- If you are over 50 or have a family history of osteoporosis, talk to your doctor about getting a bone density test.
- If you have difficulty walking or are at risk of falling, don't be shy about using a cane or walker.
Take-Home Message
- A "fractured spine" is something that can happen due to an accident or osteoporosis.
- Especially if you are over 50, don't ignore back pain that doesn't go away in a few days. Definitely see a doctor.
- Most spinal fractures do not require surgery, but do require treatment, such as wearing a brace.
- Severe back pain after an accident or fall is a sign that you should go to the ETU (Emergency Treatment Unit) immediately.
- Symptoms such as numbness in the limbs, weakness, or loss of bowel and bladder control should be considered emergencies and should be reported to a hospital immediately.
- A healthy diet and regular exercise can keep your bones strong and reduce the risk of these types of fractures in the future.
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