What is it about ?
The spine is made up of 7 cervical vertebrae (at the neck), 12 thoracic vertebrae (at the thorax) and 5 lumbar vertebrae (in the lower back), and it ends with the sacrum and coccyx. Each vertebra is made up of a vertebral body and a vertebral arch that includes protruding parts (one on the back and two on the sides) and two small joints connecting the vertebrae to each other.
The vertebral body has a structure that resembles a sponge. In the event of a fracture, the bone is usually not really broken, but sunken. Compare with a sponge that you squeeze. In the event of a fracture of the protruding parts of a vertebra, it is a real fracture. The protruding part then detaches from the vertebra.
Spinal fractures are usually caused by trauma, for example, falling from a certain height, or can even occur while sitting (in an elderly person). Old age,osteoporosis and the Bechterew’s disease are additional risk factors. With severe osteoporosis, the bones can also spontaneously sink.
How to recognize them?
Fractures of the cervical vertebrae mainly cause pain in the neck. If your neck is not painful, there is no cervical vertebra fracture. The big problem is that these fractures are often unstable. In other words, the vertebra is at risk of moving. This can damage nerve tissue and even damage the spinal cord. If nerve tissue is affected, there may be pain, tingling, and paralysis in the arm. An injury to the spinal cord causes paralysis of the part of the body below the fracture. In extreme cases, the displacement of the vertebra can completely sever the spinal cord. This is called a spinal cord injury with complete paralysis of the part of the body under the fracture.
The fracture of a thoracic or lumbar vertebra mainly causes local pain which often radiates to the surrounding back muscles. It is almost always a dent, which is usually stable. There is therefore generally no danger of displacement of the vertebra. If the nerve root is compressed, the pain may radiate to the chest or leg.
In case of fracture of the transverse protruding parts of the vertebrae, the pain is always local, that is to say at the place of the fracture.
How is the diagnosis made?
If a fracture of a vertebra is suspected, an x-ray is always taken. The doctor examines the height of the vertebral body and the protruding parts of the vertebrae, and he checks whether any vertebrae have moved. In case of radiating pain and symptoms of paralysis, a CT scan and MRI are also performed. A thorough neurological examination is also performed.
What can you do ?
If you want to help in a serious accident or a fall from a height, it is especially important not to move the victim. This will prevent you from causing damage to the spinal cord yourself. Under no circumstances move the victim’s head. Call emergency services right away and stay on site while waiting for their arrival. We always start by putting a neck brace on the victim to stabilize the vertebrae. Only then can the victim be moved.
What can the doctor do?
A fracture of a cervical vertebra requires hospitalization. Any fracture in the neck is in principle unstable; there is therefore always a risk of spinal cord injury. At first, traction can be done on the head. The neck vertebrae then move apart slightly, and the pressure on the nerve tissue decreases. Then the broken vertebra is fixed during surgery.
The treatment of a fracture of a thoracic or lumbar vertebra is in principle always conservative. This means that surgery is not done, but immobilized by requiring bed rest or wearing a special device that prevents movement of part of the spine. It is only done in case of unstable fracture and risk of spinal cord injury. The doctor also provides effective pain relief.
If he sees osteoporosis in the vertebrae, he can prescribe medication.
In the event of a fracture of the transverse protrusion of a vertebra, only painkillers are administered. Movements are permitted within the limits of pain. Immobilization of the back is not necessary in this case. Healing usually takes 6 to 8 weeks.
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