Spinal Fracture

A spinal fracture is an injury to one or more vertebrae. Some fractures happen after a fall, car crash or sports injury. Others develop when the bones are weakened by osteoporosis, cancer or another condition that affects bone strength.

Spinal fractures can occur in the neck, mid-back or lower back. Many involve the front part of the vertebra, called the vertebral body, and may cause the bone to compress or collapse. More serious fractures can affect spinal alignment, narrow the spinal canal or put pressure on nerves. Related spine conditions, such as spinal stenosis, herniated disc or spondylolisthesis, may influence symptoms and treatment planning.

Spinal fractures are described by how the vertebra breaks, whether the spine remains stable and whether the spinal cord or nerves are involved. Common types include:

• Compression fracture: The vertebra collapses, often because of osteoporosis or weakened bone.
• Burst fracture: The vertebra breaks in multiple directions, usually from a higher-energy injury.
• Flexion-distraction injury: The spine is pulled apart, often from a severe bending force.
• Fracture-dislocation: A fracture occurs with abnormal movement or displacement of the spine.
• Pathologic fracture: A weakened vertebra fractures because of cancer, infection or another underlying disease.

Understanding the fracture type helps determine whether nonsurgical care, interventional pain management, bracing or spine surgery may be recommended.

Symptoms of a spinal fracture vary depending on the location, severity and whether nerves are affected. Some fractures cause immediate pain, while others are discovered after a gradual change in posture or height.

Common symptoms may include:

• Sudden back or neck pain after a fall or injury
• Pain that worsens with standing, walking, bending or twisting
• Pain that improves when lying down
• Tenderness over the spine
• Loss of height or a hunched posture
• Muscle spasms or stiffness
• Numbness, tingling, weakness or pain that travels into the arms or legs
• Trouble walking or keeping balance

Seek urgent medical attention for severe pain after trauma, weakness, numbness, loss of bowel or bladder control, or symptoms that suggest pressure on the spinal cord or nerves.

Spinal fractures happen when the force on a vertebra is greater than the bone can withstand. In younger or healthy adults, this often requires a significant injury, such as a fall from height, motor vehicle crash or sports trauma. In older adults or people with bone loss, a fracture may occur after a minor fall, lifting movement or even coughing or twisting.

Risk factors include:

• Osteoporosis
• Older age
• Prior fracture
• Long-term steroid use
• Cancer that spreads to the spine
• Certain infections
• Low body weight
• Smoking
• Heavy alcohol use
• Conditions that affect balance

People with existing spine problems, such as spinal stenosis, sciatica or spinal tumor, may also have a higher risk of complications or more complex treatment needs after a spinal fracture.

Diagnosis starts with a physical exam, medical history and a review of how symptoms began. Your care team may check spinal tenderness, posture, strength, reflexes, sensation and walking pattern to look for signs of instability or nerve involvement.

Imaging helps confirm the fracture and guide treatment. Diagnostic testing may include:

• X-rays to show vertebral collapse or alignment changes
• CT scans to provide detailed bone images, especially after trauma
• MRI to determine whether a fracture is recent or whether the spinal cord or nerves are compressed
• Bone density testing when osteoporosis is suspected, especially after a low-impact fracture

Treatment depends on the fracture type, severity, spinal stability, pain level, neurologic symptoms and overall health.

Many stable compression fractures improve with nonsurgical care, which may include:

• Activity modification
• Pain medication
• Bracing
• Physical therapy
• Targeted pain treatments such as nerve blocks in selected cases

Some fractures need surgical evaluation, especially when the spine is unstable, the fracture is worsening, deformity is progressing or nerves are compressed. Surgical options may include:

• Decompression procedures such as laminectomy
• Stabilization with spinal instrumentation or fusion
• Minimally invasive spinal fusion for selected patients

Possible complications of a spinal fracture include chronic pain, reduced mobility, height loss, spinal deformity, worsening posture and a higher risk of future fractures. Severe or unstable fractures can narrow the spinal canal or place pressure on the spinal cord or nerves, leading to weakness, numbness, walking problems or changes in bowel or bladder function.

Complications are more likely when fractures are not evaluated, when osteoporosis or cancer is untreated, or when pain limits movement for long periods. Early diagnosis and a coordinated care plan can help protect function and reduce the risk of additional spine problems.

Not every spinal fracture can be prevented, especially those caused by major trauma. However, strengthening bones and reducing fall risk can lower the chance of many fractures, particularly compression fractures related to osteoporosis.

Prevention strategies may include weight-bearing exercise, balance training, fall prevention at home, avoiding smoking, limiting alcohol, getting enough calcium and vitamin D, and following a treatment plan for osteoporosis or other bone-weakening conditions. People with known spine conditions, such as spinal stenosis or sciatica, should also discuss safe activity modifications with their care team.

If you have sudden back pain after a fall or injury, worsening posture, loss of height or symptoms that travel into your arms or legs, schedule an evaluation with Baptist Health Brain & Spine Care. A spine specialist can identify the type of fracture, determine whether the spine is stable and recommend a treatment plan that supports healing and mobility.

To schedule a visit with a Baptist Health Brain & Spine Care provider, fill out an appointment request form or call 833-596-3876.