A “broken back,” or spinal fracture, involves a break in one or more of the 33 bones, called vertebrae, that form the spinal column. This injury can occur in any of the spine’s three main sections: the cervical (neck), thoracic (upper back), or lumbar (lower back) regions.
A spinal fracture is a serious condition that can result from significant trauma, such as car accidents, falls, or sports injuries. It can also occur in individuals with weakened bones due to conditions like osteoporosis. Prompt medical attention is important due to the risk of spinal cord damage, which can lead to neurological impairments.
Immediate Actions
If you suspect a broken back, prevent any movement of the injured person. Unnecessary movement can worsen the injury, potentially leading to or increasing spinal cord damage. Call emergency services immediately to ensure professional medical help arrives.
While waiting for paramedics, keep the person still and comfortable. Avoid moving them unless their current location poses an immediate life-threatening danger, such as a fire or an unstable structure. If movement is necessary for safety, try to maintain spinal alignment by moving them as a single unit, ideally with assistance. Do not attempt to straighten or manipulate their back or neck.
Provide reassurance and keep the person warm with blankets or clothing. Observe them for any changes in their condition, such as loss of consciousness, difficulty breathing, or changes in sensation. Report these observations to the emergency responders when they arrive.
Diagnosis and Fracture Types
Medical professionals use diagnostic tools to assess a suspected spinal fracture. X-rays are often the initial imaging technique, capable of identifying bone breaks and dislocations. However, X-rays may not reveal all types of spinal fractures or the full extent of soft tissue damage.
Computed tomography (CT) scans offer more detailed cross-sectional images of the vertebrae, allowing doctors to visualize the fracture patterns, bone fragments, and the degree of spinal canal compromise. Magnetic resonance imaging (MRI) is used to evaluate the spinal cord, nerves, and surrounding soft tissues for injuries such as bruising, swelling, or ligamentous damage. These imaging studies help determine the fracture’s stability and the potential for neurological involvement.
Spinal fractures are categorized based on their characteristics and the forces that caused them. Compression fractures, common in individuals with osteoporosis, occur when the front part of a vertebra collapses, often resulting in a wedge shape. Burst fractures involve severe compression, causing the vertebra to break in multiple places and potentially sending bone fragments into the spinal canal. Fracture-dislocations are unstable injuries where vertebrae are both broken and significantly displaced, carrying a high risk of spinal cord damage.
Treatment Approaches
Treatment for a broken back depends on the fracture’s type, stability, and whether it has impacted the spinal cord. Non-surgical approaches are often suitable for stable fractures without neurological deficits. This involves rest to allow healing and pain management.
Bracing, such as a custom-fitted back brace, immobilizes the spine and supports fractured vertebrae, maintaining alignment during healing. Physical therapy may be initiated once initial healing occurs to restore strength and flexibility.
Surgical intervention is considered for unstable fractures, those causing spinal cord compression, or when non-surgical methods are insufficient. The primary goals of surgery are to stabilize the spine, decompress any pinched nerves or the spinal cord, and restore spinal alignment. Procedures can include spinal fusion, where vertebrae are joined together with bone grafts and metal hardware like rods and screws, creating a solid bone mass over time.
Minimally invasive procedures such as vertebroplasty or kyphoplasty may be used for certain compression fractures. In vertebroplasty, bone cement is injected into the fractured vertebra to stabilize it, while kyphoplasty involves first using a balloon to restore vertebral height before injecting the cement. These procedures aim to reduce pain and prevent further collapse.
Rehabilitation and Long-Term Care
Following initial treatment, rehabilitation is important for recovering from a spinal fracture, focusing on regaining strength, mobility, and function. Physical therapy guides patients through exercises to improve muscle strength, flexibility, balance, and posture. These exercises are tailored to the individual’s injury and recovery progress.
Occupational therapy helps patients adapt to daily activities, teaching new ways to perform tasks while protecting the spine. This can include strategies for dressing, bathing, and moving safely, especially if there are lingering limitations. Pain management strategies continue throughout rehabilitation, utilizing medications, heat or cold therapy, and other modalities to control discomfort.
The recovery timeline for a broken back varies significantly depending on the fracture’s severity, type of treatment, and individual factors. Minor fractures might heal in a few months, while more complex injuries requiring surgery can involve a recovery period of six months to over a year. Long-term care may include continued physical activity, ergonomic adjustments, and regular follow-up appointments to monitor spinal health and address any persistent symptoms or challenges.