Broken vertebra

With a broken vertebra, or vertebral fracture, there is a break in the vertebral body. Vertebral fractures are divided into two groups: stable and unstable fractures. In a stable fracture, only the vertebral body is broken and the spinal cord is not at risk. This is different with an unstable fracture: because multiple bone fragments do not remain firmly in place, there is a risk of spinal cord damage.

The spine is composed from top to bottom of seven cervical vertebrae, twelve thoracic vertebrae, and five lumbar vertebrae, followed by the tailbone. The structure of the vertebrae differs by region of the spine, but they all have a vertebral body, a vertebral arch, and a spinous process. Exceptions are the first two cervical vertebrae and the tailbone, which have a completely different shape.

The vertebral arches form an opening through which the spinal cord runs. The spinal cord connects the brain to the exiting nerves. These nerves reach the fingers and toes and pass outside the spine through so-called foramina, openings between the vertebral bodies.

How does a broken vertebra occur?

There are two different causes: traumatic and non-traumatic. Traumatic fractures result from accidents such as a car crash, a fall from height, or a blow to the spine. In a non-traumatic fracture, there is no clear moment when the break occurred; this is also called a pathological fracture. In a pathological fracture, an underlying condition such as osteoporosis or bone cancer reduces bone quality, making a vertebra more likely to break.

Characteristics of a broken vertebra

A stable vertebral fracture, meaning without displacement of bone fragments, does not always cause severe symptoms. However, spinal movements are often limited and may be accompanied by a dull pain.

In an unstable vertebral fracture, the symptoms are more severe. If the spinal cord is damaged, paralysis and sensory disturbances can occur. In more severe cases, depending on the location of the fracture and the degree of spinal cord injury, a spinal cord injury can result, in which the nerve pathways in the spinal cord at the level of the fracture are irreversibly damaged.

How is a broken vertebra diagnosed?

The patient's history, combined with a physical examination, may lead the primary care physician or physical therapist to suspect a vertebral fracture. The fracture must always be confirmed with tests at the hospital. A X-ray or CT scan can determine whether the fracture is stable. This is important for choosing the right treatment. An MRI scan can visualize damage to the spinal cord and nerves in detail.

Treatment of a broken vertebra

Treatment depends largely on the type of fracture and any damage to the spinal cord and nerves. A stable fracture is often treated with bed rest, possibly combined with wearing a supportive brace while sitting, standing, and walking.

With an unstable fracture, surgery is usually performed to repair the break. This choice is made to immediately reduce or prevent damage to the spinal cord and nerves. A period of mandatory bed rest follows. The spine may only be moved again once the fracture has healed sufficiently.

During the rest period, a physical therapist can already be helpful by providing tips and advice, such as learning proper lying or sitting positions within your pain tolerance, and activity guidelines to remain as independent as possible in the first weeks.

After this period of rest, the back must be made stronger and more mobile again. Guidance by a physical therapist is strongly recommended. Find a physical therapist near you to guide you through this.