Spinal Fractures: Causes, Symptoms, and Treatment Options

Approximately 70% of spinal fractures occur in the thoracic and lumbar vertebrae. These fractures can result from trauma or accidents, but may also be caused by osteoporosis or stress fractures.

The most commonly injured area is the junction between the thoracic and lumbar spine—specifically the 12th thoracic (T12) and 1st lumbar (L1) vertebrae, the most mobile segment of the spine.

Types of Spinal Fractures

Compression Fractures & Burst Fractures

When a bone is subjected to excessive force, it can fracture. The most common type is a compression fracture, where the front part of the vertebra collapses. If the force is greater, the middle and rear parts of the vertebra may also break, potentially pushing bone fragments into the spinal canal. These are known as burst fractures, and they frequently lead to spinal cord injuries and paralysis.

Fracture-Dislocations

In more severe trauma, not only can the vertebra break, but the intervertebral discs, ligaments, and joints that hold vertebrae together may also be damaged. This leads to dislocation between vertebrae, known as a fracture-dislocation. These injuries typically involve spinal cord damage and are harder to heal, often requiring surgical intervention.

Symptoms of Spinal Fractures

Early symptoms often include:

• Pain in the neck, back, or lower back
• Muscle spasms

If the spinal cord is injured, patients may also experience:

• Numbness or loss of sensation in arms or legs
• Muscle weakness
• Incontinence or difficulty urinating/defecating

Late-stage symptoms can include:

• Kyphosis (hunchback deformity) and chronic pain if the fracture is left untreated in patients without nerve damage
• Sensory loss or paralysis in patients with nerve involvement

What Causes Spinal Fractures?

• In younger individuals, spinal fractures are typically caused by high-energy trauma such as falls from heights or car accidents.
• In older adults, especially those with osteoporosis, fractures can occur from minor trauma—or even spontaneously.

In osteoporotic patients, spinal fractures are often marked by:

• Sudden onset back pain without trauma
• Pain that worsens with standing or walking, but improves with rest
• In untreated cases: limited spine mobility, loss of vertebral height, and persistent pain
• In severe cases: neurological deficits, even paralysis

Emergency Management

Immediate transfer to a medical facility is critical when a spinal injury is suspected. Incorrect positioning during transport can significantly worsen the injury. In the emergency department, associated injuries such as internal organ damage, fractures in other areas, and head trauma should also be carefully assessed.

Who Is Most Affected by Spinal Fractures?

• 80% of spinal fracture patients are between the ages of 18 and 50
• Men are four times more likely than women to suffer spinal fractures

Principles of Spinal Fracture Treatment

Treatment depends on:

• The type of injury
• Presence or absence of spinal cord damage

Non-Surgical Treatment

Patients with isolated compression fractures that do not affect the spinal cord or soft tissues may be treated conservatively with:

• Bed rest
• Back brace (orthosis)

Most can return to daily activities within 10 days, while brace use continues for 3 to 6 months.

Surgical Treatment

Surgical intervention is required if:

• The fracture is unstable
• There’s a fracture-dislocation
• There’s spinal cord injury or a high risk of it

Surgical procedures often involve:

• Posterior instrumentation using rods and screws to stabilize the spine
• Minimally invasive techniques, which reduce postoperative pain and hospital stay
• Decompression surgery if there’s nerve damage, to relieve pressure on the spinal cord

Osteoporotic Fractures: Vertebroplasty and Kyphoplasty

For fractures caused by osteoporosis:

• Vertebroplasty: Bone cement is injected into the vertebra to relieve pain and stop further collapse
• Kyphoplasty: A balloon is first inserted and inflated to restore vertebral height, followed by cement injection

Both are minimally invasive, performed under fluoroscopic guidance, and without open incisions.

Innovative Treatment: Spinal Stenting

Our clinic, like leading centers worldwide, has adopted spinal stent technology for vertebral fractures. In this method, small cages (stents) are inserted into the vertebra to restore height and stability. Patients typically return to daily activities quickly and pain-free after this treatment.