Spinal Fractures

The spine may not seem like it to many people, but it is one of our most vital organs. It is the main support of the human skeleton and also protects the spinal cord. The spine is made up of 33 bones called vertebrae, which allow for common movements in daily life, such as bending.

A spinal fracture is a deformation or fracture of one or more of the parts of the spine (vertebrae) caused by any cause. These fractures can occur as a result of events and factors such as car accidents, general injuries, firearms, spinal tumors, trauma, or osteoporosis, which can occur with advanced age. In severe cases, it can cause paralysis, while in some cases it can lead to the development of kyphosis-like deformities.

Spinal fractures can have different names depending on how they occur. It would not be wrong to say that there are 3 different classes of spinal fractures. These are collapse fracture, burst fracture and fracture dislocation.Spinal fractures can be caused by external forces acting on the spine and, in some cases, by spinal tumors or age-related deformities. A compression fracture is the most common type of spinal fracture. It is caused by a collapse of the front part of the vertebrae due to the weight on the spine. As this weight increases, a burst fracture occurs, which can lead to paralysis. A fractured dislocation is a fracture of the discs that connect the vertebrae. Often, the broken bones damage the vertebrae and paralysis occurs.

Symptoms of Spinal Fractures

The most common symptoms of spinal fractures are neck, back, and lower back pain. Symptoms can vary depending on the severity of the fracture. Minor fractures may cause pain, but if the spinal cord is also damaged in the fracture, symptoms such as numbness in the limbs and incontinence may be observed. In severe cases, if the fracture is left untreated in the future, serious consequences such as spinal deformities such as kyphosis (hunchback) and paralysis may be observed.

• The symptoms of a spinal fracture can be listed as follows
• Back and neck pain, depending on the severity of the fracture
• Problems with the excretory system (urine and feces)
• Paralysis
• Other spinal deformities
• Loss of feeling in arms and legs

Spine Fracture Treatment

There are generally two treatment options for spinal fractures: Surgical and non-surgical. Treatment options depend on the type and severity of the fracture. Most spinal fractures are compression fractures and burst fractures in the front part of the vertebrae. The type of fracture and damage to the spinal cord determine the treatment of spinal fractures.

Collapse fractures are usually not treated surgically.  The use of a brace and bed rest are recommended to prevent deformity. The aim is to speed up the healing process by limiting the movement of the spine.  However, in cases where the fracture is much more severe, such as burst fractures and fracture dislocations where the spinal cord is or may be damaged, surgery is used. In these cases, screw rods are generally preferred.

Spinal Fracture Brace Treatment

Non-surgical treatment is preferred for some non-severe spinal fractures. Bracing is used primarily for collapse fractures where there is no deformity of the spinal cord, i.e., the spinal cord was not damaged during the fracture. Collapse fractures make up the majority of spinal fractures and are more common in women than in men.

During treatment, bed rest and painkillers are recommended. Pain in this type of spinal fracture can be persistent and last up to 3 months, but usually subsides slowly within 1 week. The duration of bed rest in non-surgical treatment should be adjusted by the doctor. Constant immobilization may accelerate osteoporosis (bone loss).

In the most general sense, a spinal fracture brace is used to limit the movement of the fractured area, i.e. the spine, and accelerate the healing process. It is usually used for 3 months, depending on the patient’s condition.  Like other corsets, it is made individually and different materials can be used in its construction. It is generally preferred for collapse fractures due to osteoporosis, depending on the severity of the case.

Spine Fracture Surgery

The majority of spinal fractures are compression or burst fractures. This condition is more common in women than in men. Depending on the severity of the injury, a brace and physical therapy are often sufficient, but in some cases, spinal fracture surgery may be required.

Most patients who are afraid of surgery ask themselves: “Will the spinal fracture heal on its own?” They wonder. However, this is not possible if the fracture is serious. For simple fractures, the spontaneous healing process can be accelerated with corset treatment and auxiliary exercises, but for serious fractures, surgery will be necessary. Especially in spinal fractures caused by osteoporosis, surgery may be preferred to prevent the development of the disease, relieve pain and improve quality of life.

There are 3 main surgical procedures that are preferred for spinal fractures. These vary depending on the patient’s history and the doctor’s preference. Types of Spinal Fracture Surgery:

1. Vertebroplasty,
2. Kyphoplasty and
3. Spinal fusion surgery.

Risks of surgery;

As with all surgical procedures, there are some risks associated with spinal fracture surgery.

• Bleeding
• Allergy reaction to drugs used in the surgical procedure
• Bone cement leaking out of the material and causing chronic back pain
• Increased pressure on the vertebrae during fusion treatment leading to fractures
• Regional or complete paralysis

In general, these are the risks of spinal fracture surgery. Of course, it would be much more useful and correct to consult your doctor about this issue.

Vertebroplasty

Vertebroplasty is a procedure in which bone cement is injected into the vertebral body, which is generally preferred for vertebral collapse fractures due to osteoporosis and some severe fractures. Vertebroplasty is performed to strengthen the bone and relieve pain. With this type of treatment, patients are able to perform their daily activities in a short period of time.

After the patient is placed on his or her back under local anesthesia, a scope is used to determine the area to be treated and bone cement is injected. Of course, vertebroplasty carries some risks. If the cement is not injected properly, the patient may experience pain in the following periods. If the bone cement leaks into the tissues or discs around the spine, the patient may experience chronic back pain. In more severe cases, the patient may experience paralysis and some pulmonary complications.

Risks of vertebroplasty

• Paralysis (may be localized or complete)
• Fractures
• Vascular occlusion in the lungs
• Chronic back pain

Kyphoplasty

Kyphoplasty is another procedure used to treat spinal fractures caused by osteoporosis (bone loss). Kyphoplasty is used to reduce spinal pain in the short term, to prevent kyphosis, which is usually caused by vertebral collapse, and to restore quality of life.

It involves placing an inflatable material in the area and restoring the vertebral height to normal levels. The materials placed in the patient’s vertebrae are filled with bone cement. The patient is usually discharged from the hospital the same day, but recovery may take a little longer. The kyphoplasty procedure takes about 1 hour.

Fusion Therapy

Fusion therapy for pain relief is based on the principle of compressing two vertebrae. Compression is achieved by inserting metal screws into the vertebrae. This holds the vertebrae together and limits their movement. First, the metal screws are fixed to the bones and movement is restricted. Then, the spaces between the vertebrae are filled with an artificial filling.

Unlike kyphoplasty and vertebroplasty, fusion is recommended as a last resort. There are several reasons for this, but fusion surgery takes much longer to heal than other types of treatment. Depending on the severity of the case and the patient’s condition, recovery can take anywhere from 2 to 6 months, and spinal motion will be limited to some degree after treatment. However, the technique used in fusion surgery can also be the cause of vertebral fractures. The fusion puts more pressure on the adjacent vertebrae than on the other vertebrae.

After Spine Fracture Surgery

Surgical treatment of spinal fractures can be easily performed today without any problems. However, the treatment process does not end with the surgery. The patient-doctor relationship must be maintained and the doctor’s instructions must be followed to the letter.

How many days does it usually take for spinal fractures to heal? Patients are curious and want to return to their daily lives immediately. After spinal fracture surgery, the patient can usually be discharged after 3 to 4 days, depending on the patient’s general condition.

In most cases, it is advisable to follow the doctor’s advice on sitting and lying positions and to use supportive braces. Avoiding sudden movements will prevent possible complications. Afterwards, it may be necessary to undergo rehabilitation according to the doctor’s advice.

It is not recommended to leave the house for the first 3 weeks. After this period, he/she can go out, provided that it is controlled. For up to 4 weeks, his/her movements should be limited. Exercise should be avoided, but short and non-paced – non-sporting – walks can be done. Only after half a year can sports such as running and swimming be practiced.

Initially, it is not advisable to drive a car or use public transportation, but from the 2nd month, he/she can use public transportation. One year after the surgery, the patient can return to his/her normal life, but should avoid competitive sports or sports for excitement (jumping, boxing, bungee jumping, etc.).

These are the things to consider after spinal fracture surgery.

Of course, you should consult your doctor and plan the appropriate treatment method and process together. Because the information here is general, it may not be appropriate for every patient and may worsen your condition.