You may have a spinal fracture from a car accident, fall, or other injury. Or you may develop painful cracks in your vertebrae from osteoporosis, a disease that makes your bones weak.
Spinal fractures are common, especially among women. They are more serious if the spinal cord gets damaged.
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What Are Spinal Fractures?
A spinal fracture is a break in any of the bones (vertebrae) that form your spinal column. You may hear this break called a fractured vertebra, spinal fracture, or vertebral column fracture.
A traumatic force can cause one or more vertebrae to break. You may also have fractured vertebrae if your bones are weak, a condition called osteoporosis.
Doctors group vertebrae into several different areas:
- Cervical (neck) bones.
- Thoracic (mid-back) bones.
- Lumbar (lower back) bones.
- The sacrum.
- The tailbone, or coccyx.
The vertebrae are separated by discs that provide cushioning. The discs are made of cartilage, collagen, and water. Ligaments hold the vertebrae and discs together.
The spinal column, also known as the spine or backbone, helps protect your spinal cord. The spinal cord is the bundle of nerve fibers that connects your brain to the rest of your body. Together, the brain and spinal cord make up the central nervous system, which helps control your body’s functions.
Fractured vertebrae range in severity. The most severe fractures cause injury to the spinal cord and can lead to paralysis.
What are the types of spinal fractures?
Fractures can occur at any part of the spine but are most common in the thoracic or lumbar vertebrae.
Spinal injury types include:
Compression fracture
This happens when the front of the vertebra breaks and becomes compacted. While these fractures can be painful, compression fractures are usually stable — meaning the bones don’t move out of place. They are common in older people with osteoporosis.
Burst fracture
Burst fractures are typically high-energy injuries. They typically happen in car accidents or falls from heights.
This type of fracture can be stable or unstable. In an unstable fracture, the bones move out of place.
In a burst fracture, pieces of bone can push into the spinal canal and press on the spinal cord or nerves. The vertebra loses height in both the front and back, so the spinal column itself loses height.
Chance fracture
These injuries commonly occur at the thoracolumbar junction, which connects the lumbar and thoracic spine.
This unique fracture occurs when your spine gets forced forward while being pulled apart at the same time. It typically happens in a car crash where someone is wearing a lap belt without a shoulder restraint. People with chance fractures often have injuries to organs in the belly (abdomen) as well.
In severe cases, the vertebrae can be completely pulled apart. This results in an unstable fracture and possible neurologic injury.
Fracture-dislocation
This is a very severe injury that involves multiple bones. A fracture-dislocation happens when a vertebra moves off an adjacent vertebra. These are highly unstable injuries and often cause spinal cord damage.
How common are spinal fractures?
Spinal fractures are common. There are about 700,000 spinal fractures from osteoporosis alone each year in the United States. They are the most common type of fracture caused by osteoporosis, more common than hip or wrist fractures.
What causes spinal fractures?
Spinal fracture causes include:
Trauma
Any significant impact can cause a spinal fracture, including:
- Falls from significant heights.
- Motor vehicle crashes.
- Sports injuries.
- Violence, including gunshot wounds.
Weakened bones from osteoporosis
For older adults with osteoporosis, a major trauma isn’t necessary to cause a spinal fracture. It can happen after:
- Coughing.
- A fall from a standing height.
- Lifting a moderately heavy object.
- Reaching for an object.
- Sneezing.
Other underlying health conditions
Tumors and other health problems also can weaken vertebrae and lead to fractures.
Spinal fracture risk factors
- Alcohol abuse.
- Anorexia.
- Being female.
- Kidney disease.
- Medications like proton pump inhibitors.
- Older age.
- Prolonged use of corticosteroids.
- Smoking.
- Vitamin D deficiency.
Complications of spinal fractures
- Loss of height.
- Loss of mobility.
- Paralysis.
- Spinal disability.
- Spinal deformity.
How can I reduce risks of spinal fractures?
You can’t prevent all spinal fractures. But you can decrease your risk of bone fracture from osteoporosis by:
- Doing weight-bearing exercise like walking or jogging.
- Getting enough calcium and vitamin D in your diet.
- Limiting alcohol.
- Not smoking.
- Strength training.
What Are the Symptoms of Spinal Fractures?
The most common symptom of a spinal fracture is neck or back pain that gets worse with movement. You may also experience swelling in the injured area.
If the fracture is affecting your spinal cord, symptoms may include:
- Difficulty moving or walking.
- Pain radiating down your arms and/or legs.
- Paralysis.
- Problems with bodily functions, such as bowel or bladder problems.
- Weakness or numbness in your arms and/or legs.
When should I see a doctor about my spinal fracture symptoms?
If you have a traumatic spinal injury from a car crash or fall, you’ll get transported to the nearest emergency department (ED). You’ll also need immediate medical help if you have:
- Loss of bladder or bowel control.
- Severe pain, to the point where you can’t move.
- Sudden numbness or tingling in your arms, feet, legs, or hands.
- Trouble breathing.
If your injury is more subtle, you may not know when to seek care for suspected spinal fracture symptoms.
You should see your medical provider if you have:
- A hunched-over posture.
- Noticeable height loss.
- Persistent back or neck pain that lasts for weeks or doesn’t improve with rest.
How Do You Diagnose Spinal Fractures?
Spinal fracture diagnosis depends on how the injury occurred.
If there was trauma, emergency responders perform the first assessment and then transport you to a hospital.
Emergency department teams perform a more thorough physical exam. They also run neurological tests to see if there are spinal cord or nerve injuries. This involves checking your reflexes and sensations in various body parts.
If there’s no trauma, your provider will begin with a physical exam. The exam can help determine if pain is coming from your bones, muscles, or another source. They may also perform neurological tests to see if there are problems with your spinal cord.
Tests to diagnose spinal fractures
Your provider may order the following imaging tests to get a more complete look at your fracture. These tests can provide or confirm a diagnosis:
How Do You Treat Spinal Fractures?
The goals of spinal fracture treatment are to:
- Allow for early movement.
- Reduce pain.
- Relieve pressure on the spinal cord and nerves and protect nerve function.
- Return the vertebrae to their original position.
- Stabilize the fracture.
Spine injury treatment may depend on the severity of your injury. You may or may not need surgery to repair a spinal fracture and other damage.
Nonsurgical treatment for spinal fractures
For less severe spinal fractures, you may not need surgery.
Treatment may involve:
- Decrease in physical activity to help your injury heal.
- Pain medicine.
- Physical therapy as you begin to heal.
- Wearing a brace to help the bones stay in place as they heal.
Surgical treatment for spinal fractures
If you have an unstable fracture, an injury involving the spinal cord, or if nonsurgical treatment isn’t helping, you may need surgery. Depending on your injury, a minimally invasive procedure may be possible.
Common spinal fracture procedures include:
- Kyphoplasty — In this minimally invasive procedure for compression fractures, a surgeon puts a balloon device into a vertebra and inflates it. After deflating the balloon, the surgeon injects a cement-like substance into the space the balloon created. The procedure can stabilize the bone and relieve pain.
- Spinal fusion — This surgery joins two or more vertebrae together, using bone or metal rods and screws.
- Vertebroplasty — This minimally invasive procedure is similar to kyphoplasty, but without the balloon. Surgeons insert a needle through a small incision into the fractured area of your spine, then inject the cement-like substance.
If a spinal fracture results from trauma, other lifesaving procedures may be needed before spinal surgery. If the injury involves the spinal cord, other procedures, such as laminectomy, may be necessary. A laminectomy relieves pressure on the spinal cord by removing all or part of the lamina, the bony arch at the back of the vertebrae that covers the spinal cord.
How effective is treatment?
Overall, treatment for spinal fractures is very effective. It can help reduce pain and improve your ability to function.
Any surgery comes with certain risks. Risks of spinal fracture surgery include:
- Bleeding
- Blood clots
- Infection
- Nerve damage
- Pulmonary embolisms
How long does it take to recover after treatment for a spinal fracture?
Recovery time for a fractured spine vertebra injury depends on the extent of your injury and the procedure.
For minor procedures, you may be able to resume normal activities within a day. For more severe fractures, you may need a lengthy hospital stay and rehabilitation.
For the most severe injuries, especially if the spinal cord is involved, you may not be able to regain full function.
Why Choose UPMC for Spinal Fracture Care?
At UPMC, we provide comprehensive care for a wide range of spinal fractures. We offer:
- A team approach — From diagnosis to treatment, our multidisciplinary team of experts offers world-class support to each patient.
- A wealth of experience — Our orthopaedic surgeons have years of experience in treating the most challenging cases.
- Ongoing care. Our rehabilitation services provide patient referrals when therapy is needed.
Additional Common Questions
Can a spinal fracture heal without surgery or treatment?
Spinal compression fractures may be able to heal without surgery. But you still need some form of treatment for a compression fracture to heal properly. You may need bracing and pain management to help the bone heal in a stable position.
Can you still walk with a fractured spine?
You may still be able to walk with a spinal fracture, especially if your spinal cord is not injured. However, it may be painful, and walking could make the pain worse.
What is the life expectancy of a person with a spinal fracture?
There’s not one answer. It depends on the kind of fracture, any other health conditions, and your age. A spinal fracture is rarely a direct cause of death.
What questions should I ask my provider about spinal fractures?
- How long will it take me to recover?
- What can I do to prevent spinal fractures in the future?
- What kind of rehabilitation will I need after spinal fracture treatment?
- Will I need surgery — and if so, what kind?
