What Conditions Are Most Commonly Caused?
In our daily lives, a significant portion of spinal injuries is caused by traffic accidents and falls from heights. Spinal fractures and injuries can occur in any part of the spine, from the neck to the tailbone. Spinal injuries are most commonly seen in the junction between the thoracic and lumbar vertebrae (T12 – L1), which is the most mobile part of the spine. 70% of fractures occur in the thoracic and lumbar vertebrae, 5-10% in the cervical vertebrae, and the remainder in lower regions.
What Are the Symptoms?
Patients may experience neck, back, or lumbar pain depending on the location of the lesion. A sudden onset of neck, back, or lumbar pain is typical following trauma. Pain worsens with standing or walking. Spinal fractures due to osteoporosis can develop without trauma. In fractures caused by osteoporosis, the pain may be tolerable, allowing the patient to continue with daily activities without noticing the fracture.
A compression fracture of the spine can lead to a loss of height over time, disrupting the posture of the spine and causing a condition called “kyphosis” or hunchback. If a spinal fracture causes damage to the spinal cord or nerves, various forms of paralysis can occur. The patient may be unable to move their arms or legs, and this weakness may be accompanied by loss of sensation. Control over urination and defecation may also be impaired.
How Is It Diagnosed?
The patient’s history, complaints, and examination findings are crucial for diagnosis.
- X-ray (Direct Radiography): The first examination for patients suspected of injury. It often successfully shows the alignment of the spinal bones, compressions, and displacements in the spinal bones.
- Computed Tomography (CT): Provides detailed information about the structures of the spinal bones. Clearly shows bone fragments that have entered the spinal canal. Provides information about the amount, shape, and type of fracture.
- Magnetic Resonance Imaging (MRI): Provides more information about the soft tissues in the spine. It provides detailed information about the spinal cord, nerve tissue, cartilage, ligaments, and connective tissue. This allows for a thorough evaluation of spinal cord injury, traumatic herniations accompanying spinal fractures, bleeding around the spinal cord, and ligament and connective tissue tears.
How Is It Treated?
Conservative (Protective) Treatment
Conservative protective treatment is often sufficient. The primary goal here is to reduce the movement of the traumatized spine to both speed up healing and reduce pain. Bed rest may be applied with a corset for varying durations depending on the shape and location of the fracture. Pain relievers, movement restriction, use of a corset, and medications to increase bone strength and density can allow the bone to heal on its own. Surgical treatment is attempted in cases where medical treatment is insufficient.
What Is Surgical Treatment? When Is It Necessary?
Surgery is required in patients where pain cannot be controlled or where the compression in the spine is at critical levels. The primary goal is to relieve the spinal cord and nerve roots that are under pressure.
- Minimally Invasive Surgery: In this method, under local anesthesia and special imaging techniques, thick needles are inserted into the fractured area to either elevate the collapsed part with cement (kyphoplasty) or directly fill it (vertebroplasty). This relieves pain in the collapsed spine and strengthens the spine. Patients can be discharged on the same day or the next day after these procedures.
- Spinal Fusion Surgery: In some cases, patients are not suitable for this treatment. In such cases, open surgery is performed. Open surgery involves removing bone fragments that are compressing the spinal cord. The fragmented spinal bodies are replaced with metal cages or supportive bone structures. Additionally, titanium screws and rod systems may be used to stabilize the alignment of the spine and restore its load-bearing capacity. Grafts taken from the body or prepared externally may be used to support and enhance bone fusion.
Frequently Asked Questions
A spinal compression fracture is a condition where one or more vertebrae in the spine collapse, typically due to causes such as osteoporosis, trauma, or bone degeneration. Osteoporosis is a condition characterized by decreased bone density, which can weaken the vertebrae and lead to fractures. Trauma, such as falls, accidents, or heavy lifting, can also cause spinal compression fractures.
Symptoms of a spinal compression fracture include sudden or gradually worsening back or lower back pain, loss of height, hunching (kyphosis), and limited mobility. The pain usually worsens while standing or walking and may decrease with rest. In some cases, nerve compression may cause numbness, tingling, or weakness in the legs.
The treatment of spinal compression fractures varies depending on the severity of the fracture and the overall health of the patient. Treatment options may include:
Conservative Treatment: Methods such as rest, pain relievers, muscle relaxants, physical therapy, and the use of braces. These treatments can aid in the natural healing process of the fracture.
Minimally Invasive Surgery: Procedures like vertebroplasty or kyphoplasty may be performed to correct the compression fracture and stabilize the vertebra. Vertebroplasty involves injecting a special cement into the fractured vertebra. Kyphoplasty involves inserting a balloon into the vertebra to restore its height, followed by cement injection.
Surgical Intervention: In cases of more severe fractures or those not responding to conservative treatment, surgical intervention may be necessary. This can involve stabilizing the vertebrae or correcting spinal alignment using metal implants.
