A “broken back” is a spinal fracture, a break in one or more vertebrae. The impact on walking ability is complex, varying significantly with the fracture’s nature and location.
Understanding Spinal Fractures
The spine’s vertebrae form the spinal column, supporting the torso and protecting the spinal cord. A spinal fracture occurs when one or more vertebrae break, often due to trauma like accidents or falls. Osteoporosis, which weakens bones, can also cause fractures from minor impacts.
Different fracture types affect mobility distinctly. Compression fractures involve the front of a vertebra collapsing, common with osteoporosis. These are stable and less likely to cause nerve damage. Burst fractures are more severe; the vertebra breaks into multiple pieces, potentially sending fragments into the spinal canal. Fracture-dislocations are unstable injuries where the vertebra fractures and moves out of alignment, risking spinal cord injury.
Fracture location along the spine also influences the potential outcome. The spine has three regions: cervical (neck), thoracic, and lumbar. Most spinal fractures occur in the thoracic or lumbar spine. Injuries in higher regions, especially the cervical spine, can have more widespread effects.
How Spinal Injuries Affect Mobility
Walking ability after a spinal fracture depends on whether the spinal cord or nerve roots are affected. The spinal cord, a nerve bundle in the spinal canal, transmits signals for movement and sensation. Damage to the spinal cord, such as compression or tearing, disrupts these signals, potentially causing weakness or paralysis below the injury.
Spinal cord injuries are complete or incomplete. A complete injury results in total loss of sensation and movement below the injury level. An incomplete injury means some nerve signals still pass through, allowing for remaining function. The extent of this damage directly dictates the degree of mobility impairment. Even without direct spinal cord damage, a fracture can pinch nerve roots, causing localized pain, weakness, or numbness.
Spinal instability can also prevent walking. An unstable fracture occurs when injured vertebrae move out of alignment, risking further spinal cord or nerve root damage with movement. This instability can make bearing weight or moving dangerous or impossible, even if the spinal cord remains intact.
Pathways to Recovery and Rehabilitation
Recovery begins with immediate medical care, including emergency stabilization and diagnostic imaging like X-rays, CT scans, and MRIs. Treatment varies based on fracture stability and spinal cord involvement. For stable fractures without nerve damage, non-surgical management is often recommended.
Non-surgical treatments include bed rest, pain management, and wearing a back brace for support and limited movement. Most compression fractures heal within three months with these measures. Physical therapy strengthens back muscles and improves overall strength, even during healing.
Surgical intervention may be necessary for unstable fractures, nerve compression, or when non-surgical methods fail. Common procedures include vertebroplasty and kyphoplasty, injecting bone cement to stabilize the vertebra. Spinal fusion may also join vertebrae, providing stability and decompressing the spinal cord.
After initial treatment, rehabilitation is continuous. Physical therapy helps regain strength, flexibility, and balance, often including gait training. Occupational therapy addresses daily living activities. Assistive devices like walkers or wheelchairs may support mobility during recovery.
Prognosis for Walking After a Spinal Fracture
Regaining walking ability after a spinal fracture depends on several individual factors. Stable compression fractures generally have a better prognosis than unstable burst fractures or fracture-dislocations. The completeness of any spinal cord injury is a major determinant. Individuals with incomplete spinal cord injuries have a higher potential for walking recovery than those with complete injuries.
Injury location along the spine affects the outcome. Lower (lumbar) spine injuries often have a better walking prognosis than higher (cervical) or thoracic injuries. Timely treatment, including emergency care and surgery, can improve outcomes by preventing further damage. Younger, healthier individuals tend to recover more effectively.
Consistent commitment to rehabilitation is a significant factor in maximizing recovery. Some individuals may regain full walking ability, others achieve mobility with assistive devices, and some experience lasting paralysis. Recovery after an incomplete spinal cord injury is variable, with 20% to 75% regaining some walking capacity within a year.