The spinal column is the bony protector of the spinal cord. It is composed of seven cervical, 12 thoracic and five lumbar vertebra as well as the sacrum. Fractures in the spine may include the vertebral body and its attachments such as the facet joints, pars articularis, lamina and spinous process. Damage to any of these bony elements may cause injury to the spinal cord and nerve structures.
Depending on the severity and site of the fracture the symptoms of a spinal fracture may include:
- Pain, which may or may not be severe
- Pain radiating into the extremities
- Swelling and bruising
- Decreased feeling in the arms, legs or body
- Muscle weakness or paralysis of the arms or legs
- Bowel/bladder dysfunction
A patient with a spine fracture should undergo a full neurological exam as quickly as possible to assess for instability and/or spinal cord injury (SCI). Diagnosis is made based on the incident, symptoms, a physical examination and results of radiological tests including the following:
Computed tomography scan (CT or CAT scan)
A diagnostic image created after a computer reads x-rays that can show the shape and size of the spinal canal, its contents, and the structures around it.
Magnetic resonance imaging (MRI)
A diagnostic test that produces three-dimensional images of body structures using powerful magnets and computer technology and can show the spinal cord, nerve roots and surrounding areas as well as enlargement, degeneration and tumors.
Application of radiation to produce a film or picture of a part of the body that can show the structure and alignment of the vertebrae and the outline of the joints.
Treatment varies and depends on the following factors:
- Severity of the fracture
- Associated dislocation or instability
- Spinal cord or nerve injury, with muscle weakness or paralysis
A minor fracture is often treated with a collar or brace worn for six to eight weeks until the bone heals on its own. A more severe or complex fracture may require traction or surgical interventions including spinal instrumentation (fusion, etc.), with or without surgical decompression.
Surgical decompression of the spinal cord is often done quickly after an injury occurs. Surgery involves the removal of various tissue or bone fragments that are compressing and comprising the spinal cord.