Sebastian Lattuga MD provides patient education materials on spinal fractures A spinal fracture is referred to as a vertebral compression fracture because when a vertebra breaks, it typically collapses and becomes compressed. It’s important to seek treatment if you suspect you might have a spinal fracture. Early treatment can help restore the deformed vertebra to its correct shape

1. +
Spinal Fracture
New York Spinal Specialists
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2. + Spinal fracture
 The spinal column is made up of 33 bony segments stacked
on top of one another. These segments, called vertebrae,
have an inner layer of soft bone and an outer layer of hard
bone. The round portion of bone at the front of each
vertebra is called the vertebral body.
 The bones in your spine aren’t as dense as some of the
other bones in your body. For example, the bones in your
legs are designed to withstand rigorous movement and
force. In contrast, the bones in your spine are smaller and
more “flexible” in order to accommodate a variety of
movements such as bending or twisting.
 This difference in bone architecture is one reason the bones
in your spine are more vulnerable to fracture.
 A spinal fracture is referred to as a vertebral compression Spinal column segment
fracture because when a vertebra breaks, it typically illustrating the vertebral
bodies (left).
collapses and becomes compressed.
Patient Education

3. + Causes of spinal fracture
 Advanced age
 Osteoporosis
 Low bone mineral density
 Long term use of
medication, e.g., corticosteroids
 Certain types of cancer; tumors
 Trauma, i.e., car
accident, fall, gunshot
Osteoporosis is one of the most
 Low levels of estrogen or
common causes of spinal fracture in testosterone
adults.
 Sedentary lifestyle
 Degenerative spine conditions
Patient Education

4. + Men: Don’t underestimate your risk
Osteoporosis is not a disease exclusive to women.
Men can have it, also.
In fact, over 2 million American men have
osteoporosis and another 3 million men are at risk
for developing the disease.
Osteoporosis can occur on its own or be caused
by medication/other diseases.
Osteoporosis risk factors for men
 Age > 50
 History of alcohol excess Osteoporosis is a silent disease. Many
people don’t know they have it until a
 Low serum levels of Vitamin D
fracture occurs.
 Prostate cancer with prolonged androgen
deprivation therapy
 Smoking, chronic obstructive pulmonary disease
Patient Education

5. + More than just a broken bone
In some ways, a spinal fracture can be more
debilitating than a broken arm or leg.
There is a hollow space in the the middle of
each vertebra that houses and protects the
spinal cord. Nerves branch off the spinal
cord, passing between the vertebrae on their
way out to the rest of the body.
Bone fragments from a fractured vertebra may
compress and damage adjacent nerves or the
spinal cord.
A spinal fracture also affects the alignment of
the spine by shortening it and pushing it
forward.
Vertebrae in the thoracic (chest) and lumbar (lower back)
regions have the greatest risk for fracture.

6. + Symptoms of a spinal fracture
 Sudden, severe pain related to trauma or specific
activity
 Mild pain that develops slowly, over time is a
common symptom. This type of pain is often
mistakenly attributed to aging or a simple
backache.
 Pain from a spinal fracture may be diffuse (spread
out) or confined to a specific area. As a general
rule, pain will worsen with movement. Sometimes
there is no pain at all.
 Multiple spinal fractures can cause stooped posture
or a protuberance of the upper back, i.e., a
dowager’s hump.
Picture your spine as a column of
blocks stacked one on top of the
 Height loss may occur with multiple fractures other. If one of the blocks changes
because, with each fracture, the spine shortens shape or collapses, it affects the
and tilts forward. entire column.

7. + Did you know?
Spinal fractures are classified as either
stable or unstable.
A stable fracture doesn’t cause significant
alterations in spinal anatomy. The spine is
still able to withstand weight and the spinal
nerves are intact.
With an unstable fracture, vertebral
deformity, nerve damage and spinal
misalignment are common.
Left untreated, a fractured vertebra will
usually heal on its own. The problem with
this is that the bone heals in the fractured Men are 4 times more likely to have a
position. traumatic spinal fracture than women.
It’s important to seek treatment if you
suspect you might have a spinal fracture.
Early treatment can help restore the
deformed vertebra to its correct shape.

8. + Types of spinal fracture
Compression fracture
Sudden downward force causes the
vertebral body to collapse. This type of
fracture is common in people with
osteoporosis or other conditions that
cause bone loss.
Wedge fracture
Similar to a compression fracture except
that only one part of the vertebral body Burst fracture
collapses. The vertebra then becomes Generally caused by trauma (fall, car
wedge-shaped. accident, etc). A burst fracture is a
significant injury that crushes the entire
vertebra. Bone fragments are displaced
and spinal cord injury may occur.
Almost half of all spinal fractures are caused by car accidents.
Patient Education

9. + How are spinal fractures diagnosed?
Spinal fractures can be overlooked
during routine exams and often go
undiagnosed. If you have back pain
unrelated to specific injury, talk with
your doctor about an X-ray.
However, be aware that spinal
fractures aren’t always visible
on X-ray.
If your X-rays are negative, but your
back pain persists, Magnetic
Resonance Imaging (MRI) is a
reasonable next step.
In certain cases, Computed
Tomography (CT) may be ordered.
Evaluation of both the clinical findings and
CT is useful for viewing soft tissue imaging studies lead to accurate diagnosis.
and changes in bony structures.
Patient Education

10. + Nonsurgical treatment for spinal fracture
Treatment goals for spinal fracture
include:
 Management of pain
 Stabilization of the fracture
Typical treatment regimen
 Pain medication
 Back brace – maintains spinal alignment;
controls pain by limiting movement
 Rest
 Gradual return to normal activity over a
period of 8 –12 weeks.
Many patients with spinal fracture
respond well to nonsurgical treatment.
Patient Education

11. + Minimally invasive treatment
Vertebroplasty and Kyphoplasty
are two minimally invasive
procedures for the treatment of
spinal fracture.
Both have been shown to
significantly reduce or eliminate
spinal fracture-induced back
pain, sometimes immediately after
the procedure.
For patients with significant loss of
vertebral height and/or
instability, spinal fusion surgery will
most likely be recommended.
Many minimally invasive procedures
offer the possibility of same day surgery
and less down time.
Patient Education

12. + Vertebroplasty vs. Kyphoplasty
How they’re similar How they’re different
Under fluoroscopic guidance, a During vertebroplasty, bone fragments
biopsy needle is inserted through a are cemented together in the fractured
small incision in the patients’ back. position.
The physician injects bone cement With kyphoplasty, balloons are first
into the fractured vertebra. inserted and inflated inside the fractured
vertebra.
The cement dries quickly, creating
an internal cast that stabilizes the Inflating the balloons expands the
fracture. compressed vertebra and restores its
normal shape, in as much as possible.
The balloons are removed and the
cement is injected.
Vertebroplasty and kyphoplasty can often be done on an
outpatient basis with the patient under light sedation.
Patient Education

13. + Surgical fusion for treatment of spinal fracture
Spinal fractures that cause neurological
problems require immediate intervention to
stabilize and align the spine.
The surgeon may recommend spinal fusion – a
procedure that “fuses” two vertebrae together
with hardware and/or bone graft.
The goal of surgical fusion is to restore spinal
stability and return the patient to an optimal level
of function.
After surgery, it takes several months for the
fused vertebrae to form one solid segment of
bone.
Abnormal movement between two vertebrae can
damage the spinal cord and nerves.

14. + Don’t ignore back pain
Once you have a spinal fracture, your risk
for another is significantly increased.
Self-diagnosis or thinking, “It can’t happen
to me” will not work to your advantage in
the long run.
Be smart. If you have back pain and/or
risk factors for spinal fracture, make an
appointment to see your doctor right away.
Early detection and treatment are the keys
to living well.
Treat a spinal fracture the same way you would
treat a broken arm. If it’s broken – fix it.
Patient Education