Spine Trauma/Fractures

Spine trauma refers to any injury to the spine, including damage to the vertebrae, spinal cord, or surrounding soft tissues such as ligaments and muscles. The severity of spine trauma can range from mild strains to severe fractures and dislocations that may lead to permanent disability.

A spinal fracture occurs when one or more of the vertebrae break due to high-impact forces, weakened bone structures, or as a combination of both. These fractures can result from traumatic injuries such as car accidents or falls, as well as underlying conditions like osteoporosis, which weaken the bones over time.

Spinal fractures are categorized based on the pattern of injury and the stability of the spine after the trauma. The most common types include:

1. Compression Fractures: These occur when the vertebra collapses due to excessive pressure, often seen in patients with osteoporosis. Many of these fractures are stable and do not require surgery. First-line treatment involves seeking care with a primary care physician, pain relief with non-narcotic pain medications, medication to improve bone quality and health, and possible bracing for comfort. Pain typically improves as the fracture heals. It is important to take vitamin D and calcium and discuss bone healthy with a primary care physician to prevent further compression fractures. It is also important to stay as active as possible to keep your bones and muscles strong.
2. Burst Fractures: A more severe form of compression fracture where the vertebra breaks into multiple fragments and disrupts the posterior wall of the vertebral body. Fracture fragments can displace and press on the spinal cord or nerve roots. This fracture type typically results from higher energy trauma that often requires evaluation in the emergency room. If associated with neurological deficits these fractures may require surgical intervention.
3. Flexion-Distraction Fractures: Occur after high energy trauma such as in car accidents, these fractures happen when the spine is forced into excessive bending, causing a break. Patients are evaluated in the emergency room and often have other injuries. These are unstable injuries that require surgical fixation.
4. Fracture-Dislocations: The most severe type, where a fracture is accompanied by dislocation of the vertebra, often leading to spinal cord damage. Patients are evaluated in the emergency room and often have other injuries. These are unstable injuries that require surgical fixation.

The symptoms of spinal trauma and fractures depend on the location and severity of the injury. Some people experience mild discomfort, while others suffer from debilitating pain and neurological deficits. Common symptoms include:

• Severe back or neck pain – Especially after trauma such as a fall or accident.
• Limited mobility – Difficulty in moving, bending, or standing up.
• Numbness or tingling – Sensory changes in the arms, legs, or torso.
• Weakness in the limbs – Indicates potential spinal cord or nerve root involvement.
• Loss of bladder or bowel control – A serious sign of spinal cord injury that requires immediate medical attention in an emergency room.
• Deformity of the spine – In cases of severe fractures, the spine may appear misshapen or misaligned.

If a spine fracture is suspected after trauma, immediate medical evaluation in an emergency room is critical to prevent further complications. Initial assessment will include a thorough history and physical exam as well as imaging such as X-rays and a CT scan. If a compression fracture is suspected in the absence of trauma, patients may seek care with their primary care physician or an urgent care as long as there are no neurologic deficits. If any neurologic deficits are present, immediate medical evaluation in an emergency room is recommended.

Spinal fractures and trauma can result from a variety of high-energy accidents, as well as medical conditions that weaken the spine. The most common causes include:

Traumatic Injuries

• Motor vehicle accidents: The most common cause of spinal fractures, especially in the cervical (neck) and thoracic (mid-back) regions.
• Falls: Falls, particularly in elderly individuals or people with osteoporosis, can cause a spinal fracture. Even a minor fall can cause vertebral fractures.
• Sports injuries: High-impact sports like football, gymnastics, or skiing can lead to spine trauma and fracture.
• Workplace accidents: Heavy lifting, falls from heights, or construction-related incidents can result in fractures.
• Violence: Gunshot wounds or direct trauma to the spine can lead to fractures or spinal cord injuries.

Medical Conditions

• Osteoporosis: A condition that weakens bones, making them prone to compression fractures.
• Cancer (Metastatic Disease): Cancer that spreads to the spine can weaken vertebrae, leading to fractures.
• Spinal Infections: Infections like osteomyelitis can erode bone structure, increasing fracture risk.