Spine fracture: Spine fracture is a serious issue and is defined as a break in the vertebrae, which can affect life like any other fracture.
Symptoms: Patient with spine fracture usually presented with:
- Back pain – the most common complaint
- Difficulty to sit/stand/walk
- Sciatica-like pain in limbs – radicular pain, tingling, numbness
- Weakness in limbs
- Bladder/Bowel involvement – incontinence
- Spinal deformity and posture changes – usually in untreated cases
Spine Fracture Causes:
- In young patients – usually due to high-impact injury like a road traffic accident, fall from height, or sports injury.
- In older patients – Osteoporosis is the leading cause. Because of low bone density, even trivial trauma, like leaning forward or sneezing, can cause a spine fracture.
- Fractures associated with:
- Tumors – usually metastatic
- Drug-induced – e.g., long-standing steroid consumption
Diagnosis: Based on clinical examination and investigations:
- MRI – the investigation of choice
- X-rays and CT scan
- Bone density tests:
- Also called BMD or DEXA scan
- Used to quantify osteoporosis
- To determine type of fixation during surgery
- For medical management of osteoporosis
Management: Depends on:
- Cause of fracture
- Type of fracture
- Site of fracture
Most spine fractures do not need surgery and can be managed conservatively.
- Pain management with medication
- Bracing – supports the back, improves strength, and prevents collapse.
- Physical therapy – helps maintain joint mobility and prevent chest issues while bedridden.
- Treatment of associated factors, e.g., osteoporosis
Surgery: Usually required when:
- Conservative treatment fails
- Pain and disability increase despite non-surgical treatments
- Nerve compression – causing weakness, bladder, or bowel incontinence
- Spine deformity
Types of Surgery:
- In young patients – spinal fixation with or without neural decompression
- In older patients – Balloon kyphoplasty or vertebroplasty, a minimally invasive procedure using special cement to fill the void created after a fracture. Maximum benefit with minimal intervention.
In some cases, fixation along with cementing is needed.
