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Fracture of any part of one or multiple vertebrae is called Spinal Fracture.

Spine Fracture
What is a Spine Fracture?

The bones of the back are called vertebra. There are a total of 32 vertebrae in the human body, which run from the base of the head till the tail bone (just above the opening for passage of faeces). These are divided into five sections –

  1. The bones of the neck are called Cervical Vertebrae and are seven in number
  2. The bones of the back are called Dorsal or Thoracic vertebrae as they correspond to the thoracic area of the human body and are twelve in number
  3. The bones of the lower back are called Lumbar vertebrae and are five in number
  4. The bones below the Lumbar vertebrae are called Sacral vertebrae and are five in number. These are joined into one single mass of bone and is commonly called SACRUM. The sacrum joins the bones of the pelvis on either sides (left and right) to complete the pelvic cavity.
  5. The bones below the sacrum are called Coccyx and are three in number.
Typically the vertebra is composed of three parts – the front part called the body, the middle part called the lamina and the rear part called the spinous process. The all important structure namely the Spinal cord is contained in the vertebra.
Fracture of any part of one or multiple vertebrae is called Spinal Fracture.

Causes

  1. Direct injury to the neck or back as in vehicular accidents or fall from height and assaults with blunt or sharp objects
  2. Indirect injury as in a forceful fall from height on heels or feet; travel on bumpy irregular roads and fall on buttocks
  3. Pathologic fracture due to various reasons like infection, tumours (to know more about pathologic fractures see our general fracture section)

Symptoms

These include –

  1. Mild to severe pain in the middle or lower back
  2. Numbness, tingling, or weakness
  3. Difficulty walking
  4. Loss of control of the bowel or bladder
  5. Quadriplegia when there is total loss of power of all four limbs and Qaudriparesis when there is weakness in all four limbs.
  6. Paraplegia when there is total loss of power of in both lower limbs and paraparesis when there is weakness in both lower limbs.
Various factors like Osteoporosis, Cancers, Use of medications like Proton pump inhibitors, antipsychotics, Poor mental functioning with or without poor mobility and strength put a person for risk of developing vertebral fractures.

Diagnosis

Detailed medical history and physical examination is carried out before ordering investigations. Images may be taken of your bodily structures. This can be done with:

  • X-rays
  • Bone scan
  • Computerized tomography (CT)
  • Magnetic resonance imaging (MRI)
Osteoporosis when suspected shall have have to confirmed with blood tests and bone mineral test – DEXA scan.
Relevant blood tests in conditions like cancers, diabetes and myeloma shall be done when necessary. Some cases may require combined care along with a neurosurgeon or neurologist. It is important that you discuss with your treating orthopaedic surgeon about detailed investigations and facilitate the same.

Treatment

Depending upon the symptoms, presence of absence of weakness in limbs, cause and type of fracture different treatments shall be proferred to you. The different modalities include –

  • Complete bed rest – usually when there is no deficit in the limbs and no compression of spinal cord.
  • Surgery is usually advocated when there is injury and compression of spinal cord due to fractured bone pressing on the nerves. It may also be needed in a patient when his neural injury develops or worsens on bed rest. Different surgical modalities include Vertebroplasty, Kyphoplasty, Decompression of spinal cord with or without fixation of the vertebrae with screws and rods or cages and wires.

  • It is advisable to discuss in detail with your treating orthopaedic surgeon about the treatment protocol and its pros and cons over 8 to 10 week duration, before taking decisions.


    What is a NECK FRACTURE?

    A neck fracture is a break in one or more of the seven cervical bones. The vertebrae are the bones that make up the spine. Neck fracture may cause - severe pain, swelling and possible bruising, decreased feeling in the arms or legs and muscle weakness or paralysis of the arms or legs.
    It is important to recognize the possibility of a neck fracture. A neck fracture is very serious and can lead to paralysis or possibly death. A person with a neck injury should not be moved without competent medical care, which is needed immediately.


    COCCYX FRACTURE

    A coccyx fracture is a broken tailbone. The coccyx is the lowest part of the backbone or spine. It is small and shaped like a triangle. The bone curves gently from the end of the spine into the pelvis. Coccyx fractures are more common in women. Risk factors that may increase your chance of a coccyx fracture include - advancing age, Osteoporosis, abnormal or absent menstrual cycles leading to bone mineral loss, menopause, decreased muscle mass, participating in certain activities, such as skating or contact sports that may lead to falls in a seated position and Violence.
    Pain that increases with sitting or getting up from a chair or hard surfaces, pain that increases after driving especially bumpy rides, pain that increases during a bowel movement and tenderness over the tailbone are the symptoms of coccyx fracture. Treatment includes rest to coccyx by using air cushions, ice fomentation and medications. If the pain becomes resistant to treatment or does not abate then surgical excision of the fractured coccyx may be done to relieve symptoms.

    Rehabilitation and Physiotherapy
    Depending on the neural injury physiotherapy may last from few weeks to few months. The patient is encouraged to indulge in more and more activities like walking and cycling beside rehabilitation exercises.

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