SPINAL FRACTURES

Spinal Fractures

A fractured spine or vertebral fracture is a medical term that describes breaking any of your vertebrae. Vertebrae are the 33 bones that build up the spinal column. Sometimes, people also refer to a spinal fracture as a broken back. Spinal injuries in children are rare injuries. However, once it occurs, the results can be quite devastating for the growing skeleton. While treating these patients the doctors should have knowledge of the accident’s causes, and clinical symptoms while proper diagnostics is also necessary.

Fractured vertebrae are usually the result of osteoporosis while traumas like falls, sports injuries, or car accidents can also be the reason. When it comes to treatment, most spinal fractures won’t need surgery. In minor cases, the patient might need to wear a brace for a few months. However, for treating severe spinal fractures, surgeries will be necessary.

Causes of Spinal Fractures

Spinal fractures or dislocation of one or more vertebrae in a spine by trauma are considered serious orthopedic damage. In most cases, these fractures occur as a result of a high-velocity accident. These can occur in the cervical spine (neck), thoracic spine (mid back), or lumbar spine (low back). 

High-velocity accidents could mean a fall from height, trauma from motor vehicle accidents, sporting accidents, etc. Other reasons can also be related to soft bones (osteoporosis). And in that case, a child could be more vulnerable to trauma. However, also, there are examples where children can develop a fracture without having any injury or trauma. And that might be caused by a disease. The more common injuries occur when the area of the spine or neck is compressed or bent as in the following:

• Birth injuries – These usually affect the cervical vertebrae which is the neck area.
• Motor vehicle accidents, driving accidents, trampoline accidents
• Sports injuries
• Violence (gunshots or stab wounds)

Fractures of the neck usually occur by a high energy trauma and these might be quite uncommon in other situations. However, any kind of cervical spine can have serious consequences because of how it is located in relation to the spinal cord. It could lead to bone fragments, pinch, and damage to the spinal cord and the surrounding nerves. Moreover, serious damage or injury to the spinal cord can even result in paralysis or death. This is why all fractures need to be evaluated to understand the current stability of the spine and prevent further damage.  

Symptoms of a Spinal Fracture

A child with a spinal fracture may have various symptoms depending on the severity and location of the fracture and whether the spinal cord has been compressed or not. Besides, a severe compression fracture may damage the spinal cord or nerve roots as well. This might lead to severe pain, paralysis, a hunched-forward deformity (kyphosis), etc. Other symptoms are:

• Mild to severe pain, and swelling
• Inability to move or walk normally
• Unnatural angle or deformity in the area

If you are suspecting a spinal injury in your child, do not attempt to move your child and call for emergency help. Make sure you immobilize your child’s head, neck, and spine by creating thick padding with towels, blankets, or jackets. Doctors can determine the severity of the damage asap. 

Types of Spinal Fractures

Compression Fracture

Compression fractures can cause the vertebrae to collapse, making the spine shorter in height. Furthermore, this collapse can make the pieces of bone press the spinal cord and nerves. Consequently, this can decrease the amount of blood and oxygen supply to the spinal cord.

Causes Of a Compression Fracture

• Osteoporosis 
• Injuries to the spine 
• Tumors in the spine, etc.

Symptoms of a Compression Fracture

In the initial phase, compression fractures may not have any symptoms. Sometimes, a healthcare provider may discover them on an X-ray while doing it for other reasons. Later, the symptoms may come up as:

• Slowly worsening back pain 
• Decrease in your height, limited spine movement 
• A gradually developing stooped-over posture
• Numbness or tingling, problems in walking, weak muscles
• Trouble in controlling your bowels or bladder as a result of nerve damage
• In case you get a sudden fracture, you may have sudden, severe, and disabling back pain.

Axial Burst Fracture

As per the severity, this type is more advanced than a compression fracture. Generally, this occurs by a fall from a significant height and then landing straight on the feet or your bottom. In this case, the vertebra loses height on both the front and back sides, decreasing the overall height of the vertebrae. The fragments of the vertebrae may separate and injure the spinal cord or the adjoined branching nerves. Also, the bone typically becomes more unstable. 

Chance Fracture

Also named a “seat-belt injury”, this fracture is caused by a violent forward flexed injury. Here, the vertebra is pulled apart from the pelvis. So, basically, these occur in the lower mid-back region. These fractures mostly need surgery because of excruciating pain and need to be stabilized.

Diagnosis of Spinal Fractures

Our orthopedic doctors will make a thorough diagnosis with physical examination and advanced diagnostic tests. Additionally, they will get a comprehensive medical history of your child and ask how the injury occurred. Our diagnostic procedures include:

X-rays: The invisible electromagnetic energy beams produce accurate images of internal problems, bones, and organs onto a film. This test helps in measuring and evaluating the curve.

CT or CAT scan: This diagnostic imaging procedure uses x-rays and computer technology to produce cross-sectional images.

Magnetic resonance imaging (MRI): This method uses large magnets, radio frequencies, and a computer to produce detailed images of structures and organs within the body. 

Treatment of Spinal Fractures

Treatment may include some combination of the following:

Brace: Our doctors use this for immobilizing the injured area and promoting bone alignment and healing. Also, this helps in reducing the eventual height loss and improving the angulation from the fracture. 

Reduction: It helps in realigning the fractured bone. Specialists do this with open reduction (by making an incision into the fracture site) or closed reduction (by external manipulation with no incision)

Traction: In this procedure, doctors apply a force to stretch particular parts of the body in a certain direction. This treatment comprises pulleys, strings, weights, as well as a metal frame attached over the bed. The objective is to stretch the muscles and tendons around the broken bone. It allows the bone to align and heal.

Surgery: Surgery might be necessary to put certain types of fractured bones back into place. Sometimes, internal fixation or external fixation devices are used to hold the bone fragments in place and thus, allow the right alignment and healing.

Determining The Right Treatment 

So, basically, the overall goal of spinal fracture treatment is restoring the normal length and alignment of the vertebrae. Our doctors will determine the specific treatment for a fracture considering:

• The age of your child, overall health, and medical history
• The severity of the fracture
• The tolerance of your child for specific therapies, medications, or procedures
• Your preferences and opinion
• Expectations for the course of the fracture

Bottom Line

How your child will heal from a compression fracture depends on how severe the damage is and the cause of the damage. As a parent, you can help your child get the best result by not missing any of the follow-up doctor visits, giving proper meds as directed, and following the doctor’s instructions regarding activities.