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Spine  Fracture

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About Spine Fracture

Spinal fractures refer to dislocations or fractures of the vertebrae (backbone) anywhere along the spine. A spine fracture can occur even after a minor fall or trauma. Many of these fractures will not require surgery, but major fractures can lead to serious long-term consequences if not treated promptly. The symptoms of a fracture may be less obvious in some cases, nonetheless, all of them require treatment.

The pain from vertebral fractures may range from moderate to severe. In severe back pain, the patient would be unable to change position and posture when getting into and out of the car, getting into and out of bed, sit to stand, or turning in bed. The pain may be localised or referred further down from the site of fracture.

What Causes Spine Fracture

There are three types of fractures: compression fracture, axial burst fracture and chance fracture. Each of these fractures can be caused by different factors.

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Compression Fracture

Compression fractures stem from patients with osteoporosis or other diseases. Fractures and deterioration occur in the front vertebrae, whereas stability is maintained in the back vertebrae.

Burst Fracture

As a result of a fall or vertical impact, axial burst fractures occur when vertebrae lose height on both sides.

Chance Fracture

Chance fractures are caused by violent forward flexion injuries that pull the vertebrae apart. Chance fractures usually occur in vehicle accidents.

The risk factors for Spine Fractures are as follows:

  • Female
  • Osteoporosis
  • Above 50 years old
  • History of back injury/vertebral fracture
  • Smokers

Symptoms Of Spine Fracture

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Pain
Pain in the back or neck is usually present in people with a spine fracture. The spinal pain makes it difficult for the patient to move with ease. It hinders all change of posture or position. Even turning in bed is fraught with intense pain.
Numbness
When the spine is fractured, protruding bones or fragments can press on the spinal cords and nerves. This results in a tingling sensation and numbness.
Other Symptoms
Some other symptoms include uncontrolled muscle spasms, loss of urinary or bowel control and weakness or paralysis of the limbs.

A Message About Spine Fracture

Spinal fracture management is similar in principle to all bony fracture management: Immobilization. Lying in bed without turning or getting up may provide short-term relief to the patient, but this may have other consequences such as bed-bound chest infection and pneumonia and Deep Vein Thrombosis from lack of movement.

Treatment of vertebral fractures can be considered with percutaneous vertebroplasty. This procedure injects cement into the fracture lines to cement them together, preventing further broken ends from inadvertent movement. Once the cement seals and hardens, the pain from the spinal fracture abolish quickly. Together with rehabilitation and osteoporosis management, the recurrence of further fractures is addressed and circumvented.

Diagnosing Spine Fracture

Here at Singapore Paincare, our team of experienced primary care doctors and pain care specialists together with an orthopaedic doctor will evaluate your condition. An X-ray, MRI or CT scan may also be needed to check the severity of the spinal fracture.

What Treatments Are Available for Spine Fracture

At Singapore Paincare, we strive to treat your pain with the least invasive option possible after accurately identifying the cause. Our approach to pain resolution focuses on the removal of pain generators via specialised injection and minimally invasive procedures. Combined with pharmacological treatments and cognitive and physical rehabilitative therapies, we help patients improve their functions and prevent pain from recurring.

Non-Surgical Treatments for Spine Fracture

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Non-Steroidal Anti-Inflammatory drugs
Prescriptions of varying medications such as NSAIDs have anti-inflammatory and analgesic effects. These drugs may help to relieve pain. Fracture pain has a dynamic component that NSAID may not alleviate movement-related pain.
Back brace
A back brace is used by our specialists and clinics in order to support and immobilise the affected area. This prevents further injuries and is used in conjunction with other treatment methods. In a limited manner, back brace may sometimes help with a spinal fracture.
Balloon Kyphoplasty
Balloon Kyphoplasty is a minimally invasive treatment that is used by our specialists for spine fractures. The procedure lifts the bone fragments into the correct position with the use of a balloon. Cement is then filled into the balloon to act as a stopper for the further collapse of the fracture ends.
Vertebroplasty
Vertebroplasty is the injection of cement into cracked bones by conditions such as osteoporosis. This method is useful to stop the fracture ends of the vertebra from rubbing against each other and to increase the stability of compressed spinal fractured bodies.
Physical Therapy
Once the fractured ends are secured and sealed by cement, rehabilitation is important to mobilise and strengthen the surrounding core and back muscles. The therapy sessions by our physiotherapists involve resistance training to reduce pain. It also consists of stretching exercises to increase the motion of the joint and minimize loss of muscle. However, the intensity and type of exercise may differ based on the conditions of the patient.

Surgical Treatments for Spine Fracture

Spine fracture that is caused by osteoporosis or illnesses can be treated with conservative methods. Surgery is usually reserved for acute cases such as car accidents or failure of conservative treatments despite attempts. As surgery always comes with associated risks, complications and downtime, it may not be suitable for everyone.

Surgery
Surgical procedures are implemented based on the type of fracture, this includes spinal decompression if there is nerve damage, laminectomy to remove parts of the bone or lumbar fusion to fuse the spine with screws and plates.

How Can I Prevent Spine Fracture?

While you can’t fully protect yourself from any accidents that may cause spinal fractures, incorporating these strategies can protect your spine:

  • Assuring proper movement during exercise and daily activities
  • For people with bone loss, proceed with caution or avoid altogether doing any of the following:
    • Carrying heavy packages
    • Reach for items on high shelves
    • Bending forward from the waist

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