Is a Spinal Fracture causing my neck or back pain?
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Is a Spinal Fracture causing my neck or back pain?
Spinal Fractures Symptoms & Treatment Options
Spinal fractures are extremely serious conditions that can lead to a wide variety of symptoms, ranging from mild in intensity to debilitating. Sudden trauma, as well as underlying medical conditions, may be to blame.
Luckily, there are both surgical and nonsurgical avenues available to address spinal fractures.
Before we delve in further, however, let’s take a closer look at your spine.
Understanding the Spine
Your spinal column is a series of 33 bones that stretches from the base of your skull to your tailbone. These individual bones are also known as vertebrae. More specifically, the main bulk of the vertebra is called the vertebral body. When viewed from the side, this structure roughly resembles an hourglass.
At the back of each vertebra, pedicles and laminae form the vertebral arch. These structures surround and protect the spinal cord. Bony protrusions known as processes form a star-like shape at the back of the spine where back muscles attach, thus enabling movement.
Functions of the spine include:
- Protecting the spinal cord, nerve roots, and internal organs
- Assisting with the motion of everyday activities such as bending, twisting, and standing upright
- Providing structural support to the body
Moreover, the spine is divided into five main regions. These include the:
- Cervical spine: Seven vertebrae located in the neck region. The cervical spine is responsible for holding up the head.
- Thoracic spine: Twelve vertebrae located in the upper and mid-back. This section of the spine holds the rib cage in place, protecting the heart and lungs.
- Lumbar spine: Five vertebrae located in the lower back. These large vertebrae help to bear the weight of the upper body.
- Sacral Spine: Five fused vertebrae located near the hips.
- Coccyx region: Four fused bones that form the tailbone, a point of attachment for muscles and ligaments to the pelvic floor.
Specifically, most spinal fractures occur in the thoracic and lumbar areas of the spine.
What are Spinal Fractures?
Vertebrae are bones. Like just about any bone in the body, they can potentially break or crack. Spinal fractures occur when an outside force applies too much pressure to a bone. In many cases, the front of the spine (i.e. vertebral body) collapses while the posterior portion maintains its height. These wedge-shaped fractures, especially when occurring in multiple vertebrae, can lead to noticeable spinal deformities like a hunched back.
What Causes Spinal Fractures?
For some, spinal fractures are the result of an accident or trauma. Falls, car accidents, sports injuries, and violent acts are some of the more common trauma-related causes. Essentially, these high-energy traumas push the spine past its breaking point.
In many cases, additional injuries are present during trauma-related spinal fractures. It is important to request medical assistance right away if you suffer a trauma that affects your spine. Severe spinal fractures could include spinal cord injuries which, when left untreated, can lead to permanent damage.
But, you don’t need to experience a bad accident to suffer spinal fractures. Underlying medical conditions can make the vertebrae more likely to break.
Medical conditions that may lead to spinal fractures include:
- Osteoporosis: As we age, our bones lose density and begin to weaken. Vertebrae affected by osteoporosis can flatten and narrow, causing spinal deformities. Resultingly, applied pressure can cause weak vertebral bodies to crack and lose their height. Even everyday activities like twisting, reaching, or even sneezing can lead to spinal fractures.
- Cancer: Those suffering from many forms of cancer can have the disease spread (or metastasize) to the spine. Breast, lung, and prostate cancers are common culprits. As tumors expand in size within the spine, vertebrae can suffer breaks.
- Infection: While less common, infections in or near the spine may weaken the bones, causing fractures.
- Previous spinal fracture: If you sustained a prior spinal fracture, you are more likely to suffer another one.
- Medications: Certain drugs like oral steroids, antidepressants, or diabetes medications can weaken the bones.
- Unhealthy lifestyle habits. Exercise helps your bones to stay strong. A sedentary lifestyle can decrease bone density. Also, smoking or heavy drinking may affect your body’s ability to absorb calcium.
Do You Think You Have a Spinal Fracture?
Have you been diagnosed with any of the conditions mentioned above? Have you recently been in an accident or taken a bad fall?
If you suspect a spinal fracture, then you should consult with your doctor or an orthopedic specialist as soon as possible. Check out the next section to review the common symptoms of spinal fractures.
What are the Symptoms of Spinal Fractures?
Symptoms of spinal fractures can vary depending on the location and severity of the injury. In most cases, one will experience some degree of pain. This can be due to structural changes in the spine that affect other parts of the body. Pain may also be a sign of injuries to nerves, nerve roots, or the spinal cord itself.
Other symptoms associated with spinal fractures include:
- Neck or back pain occurring suddenly—especially after a fall or accident
- Worsening pain while standing or walking
- Some pain relief while lying down
- Muscle spasms
- Numbness or tingling in other areas of the body including arms, hands, legs, and feet
- Height loss
- Limited mobility and range of motion
- Noticeable deformity of the spine (e.g. posture)
- Trouble controlling bowels or bladder
- Paralysis—a loss of movement in an extremity due to a spinal cord injury
If you were in an accident, you may have other injuries like head trauma. Other injuries—sometimes known as distracting injuries—cause pain that overwhelms your spinal fracture pain. Seeking immediate medical attention can allow you to pinpoint your exact injuries and determine if there were any fractures to the spine.
Diagnosing Spinal Fractures
If your spinal fractures are the result of trauma, you may need to go (or be transported) directly to an emergency room. Your injuries may necessitate immobilization with a backboard or a cervical collar during transport. From there, your ER team will collaborate to determine the extent of your injuries.
Less severe spinal fractures due to other conditions, such as osteoporosis, may require you to consult with an orthopedic specialist. However, during a routine exam, your doctor will obtain a complete medical history and ask about the onset and severity of your symptoms.
Your doctor will then conduct a physical exam. This will include inspecting the head, chest, spine, limbs, pelvis, and abdomen. Your doctor may also administer neurological tests to assess how you move, feel, and sense position in your limbs. Your reflexes will also be tested to determine any nerve or spinal cord damage.
Additionally, your doctor will likely use a variety of diagnostic imaging techniques to visualize the structures of your spine. These techniques include:
- X-rays: Simple images of the bones created by using electromagnetic waves.
- CT or CAT scan: A computer axial tomography uses x-rays and a computer to produce vivid cross-sectional images of the body. These scans help your doctor determine if the bone is stable and if any nearby nerves are affected.
- MRI scan: The magnetic resonance imaging scan uses radio waves and a magnetic field to create detailed images of the soft tissues inside the body. These images show if the tissues involved include intervertebral discs (rubbery cushions between the vertebrae) and whether the fracture is new or old.
Once a spinal fracture has been accurately diagnosed, treatment can begin. The next section highlights common treatments for spinal fractures.
What Are My Treatment Options for Spinal Fractures?
Treatment for spinal fractures depends on the severity of your injury and the associated symptoms.
If the fracture is relatively stable, then your doctor may recommend braces or orthotics. These conservative interventions maintain your spinal alignment while immobilizing your spine to aid in healing. Braces can also help to control pain by restricting the movement of the injured area.
You may need to use braces or orthotics for up to 12 weeks. During that time, you will gradually increase activity with the assistance of a physical therapist. Taking pain medications during this time may assist with some of the uncomfortable symptoms from your fracture.
Spinal Fracture Treatment Options
A minimally invasive procedure in which bone cement is inserted directly into the collapsed vertebral body. This can reduce or eliminate pain as well as stabilize the fracture.
Similar to vertebroplasty, this minimally invasive procedure inserts a balloon into the affected vertebral body before applying the bone cement. This allows for height restoration in the bone before the cement sets in.
In some cases, spinal fusion surgery may be needed to fuse two vertebrae together with the assistance of a bone graft and other surgical hardware. During an ALIF, your surgeon approaches your spine from the front or anterior side.
Similarly, during a PLIF, your doctor fuses the spine from the back or posterior side. The approach that is right for you will depend upon the specifics of your individual case.