What are Spinal Fractures?

The spine consists of 33 spinal bones. A spinal fracture(vertebral fracture) may occur in any of these bones. However, 64% of spinal fractures occur in the spinal bones in the waist and back region. 

Spinal fractures most commonly occur in the T12 and L1 spinal bones. Traffic accidents, motorcycle accidents, falls from heights, gunshot wounds, sports accidents, osteoporosis may cause spinal fractures. Osteoporosis is of great importance in such fractures. 

Osteoporosis, especially in elderly patients, causes fractures due to the deterioration of the spongiosa structure in the spinal bones and loss of their support feature. In cancers involving the spine, the tumor located in the spine can damage the bone structure and cause fractures. A fracture in the spinal bone can disrupt the patient's posture and cause pain. 

What are the Types of Spinal Fractures?

There are many different classifications of spinal fractures. Basically, it can be expressed as fractures, dislocations and fracture-dislocations. Fractures Fractures may occur as a result of the spinal bones being exposed to more load and pressure than they can withstand.

 The most common type of spinal fracture is a compression fracture, also known as a spinal compression fracture. It is often caused by conditions such as osteoporosis or tumors that cause bones to weaken. In this type of fracture, the front part of the vertebra breaks and its height decreases, while the back part remains fixed. 

These types of compression fractures result in the shape of the vertebra being wedge type rather than square. In this case, a deformity in which the spine bends forward, called kyphosis, occurs. Additionally, a fracture may occur as a result of a vertical impact on the spine, such as falling on the feet from a very high place. 

In this type of trauma, the height of both the anterior and posterior regions of the vertebrae decreases. These types of serious fractures, which cause flattening of the vertebrae, can cause pressure on the spinal cord or nerve tissue. Dislocations: As a result of excessive stretching or tearing in the ligaments and discs connecting the spinal bones, the spinal bones may shift out of their normal alignment. 

These dislocations can cause narrowing of the spinal canal and spinal cord damage. Fracture-dislocations: Situations in which there is a slippage in the spine due to a fracture in the vertebral bones and a tear in the ligaments are referred to as fracture-dislocations. This type of traumatic injuries usually requires surgical treatment. 

What are the symptoms of spinal fractures?

Pain that occurs suddenly in the waist and back area and gets worse with movement is the most common symptom of a spinal fracture. If the broken bone compresses the spinal cord and nerves, local numbness may occur in addition to pain. If the nerve roots or spinal cord is seriously damaged due to the pressure of the broken bone, sensation, reflexes, muscle strength and movements may be affected.

Nerve damage can also lead to problems such as loss of bladder and bowel control. Symptoms of a spinal fracture are usually: Waist, back or neck pain that worsens with movement, Tingling, numbness or weakness in the limbs, Muscle spasms, Bowel and bladder problems, Loss of movement in the arms and legs, Loss of consciousness-fainting in severe fractures.

It is extremely important to seek emergency medical help, especially in serious cases where there is loss of consciousness and loss of movement. Here, the person should be properly supported without being moved and wait for the emergency team to arrive. It should not be forgotten that an unconscious movement can lead to spinal fracture, spinal cord injury and paralysis. What are the Treatment Methods for Spine Fractures? There are generally two treatment options for spinal fractures: Surgical and non-surgical methods. Treatment options vary depending on the type and severity of the fracture. Most spinal fractures are collapse and burst fractures that occur in the anterior section of the vertebrae. The types of fractures and damage to the spinal cord are decisive for the treatment of spinal fractures. Compression fracture  surgical method is usually not used.  In order to prevent possible deformity, corset use and bed rest are recommended. The aim here is to speed up the healing process by limiting the movement of the spine.   However, in cases where the fracture is much more severe; Surgical method is used in burst fractures and fracture dislocations where the spinal cord is damaged or may be damaged. In these cases  Generally, screw rods are preferred. Corset or cast treatment: A fixation is required for fractures to heal. 

Corset or cast treatment is preferred, especially in patients with depression fractures, spinal cord injuries, and patients without soft tissue-connective tissue injuries. The aim is to ensure the healing of the fracture with external fixation and to prevent further collapse of the spine, spinal cord compression and the development of a hunchback. 

The duration of the cast or brace is usually 3 months. Instrumentation and fusion: The fractured spine is fixed using metal instruments and also frozen. 

This procedure can be performed from the front or back of the spine, but sometimes both sides may need to be frozen. It may take months for fusion to occur. At the same time, in patients with spinal cord injury, bone fragments compressing the spinal cord can be removed during surgery. 

It is the preferred treatment method for burst fractures where the posterior ligament tissues are injured without neurological injury, and all other burst fractures or fractures and fracture-dislocations with neurological injury. 

Vertebroplasty & Kyphoplasty: It is a minimally invasive treatment method that can be applied to some selected compression fractures, osteoporosis or tumor-related fractures, and some burst fractures. It can be applied under local anesthesia. It is based on the principle of inserting large needles into the spine through small incisions on the skin, correcting the fracture, and placing a titanium cage and/or cement inside to strengthen it.