What are traumatic spine fractures?
A fracture or dislocation of the spinal column follows significant force, a fall from height, a vehicle collision, a sporting injury. The critical questions are whether the injury is stable, and whether the spinal cord or nerve roots have been injured. Those two answers determine everything that follows.
Symptoms
- Immediate, severe neck or back pain after injury
- Pain that is worse with any attempt to move
- Numbness, tingling, or weakness in the arms or legs
- Difficulty walking or standing
- Loss of bowel or bladder control
Urgent
Call 911 for any suspected spinal injury after significant trauma. Do not move the person unless they are in immediate danger. New weakness, numbness, or loss of bowel or bladder control after an injury is a medical emergency.
How it is diagnosed
CT is usually the first detailed study after trauma, showing the fracture pattern and alignment. MRI adds information about the spinal cord, discs, and the ligaments that hold the spine together, ligament injury can make a fracture unstable even when the bones look reasonably aligned. Examination of strength and sensation is repeated over time to detect any change.
Non-surgical treatment
Stable fractures without neurological injury are commonly treated without surgery: a brace, a period of activity restriction, pain control, and follow-up imaging to confirm alignment is holding. Most heal well. Bone health is also assessed, since a fracture from relatively low force raises the question of underlying bone weakness.
When surgery is considered
Surgery is indicated for unstable injuries, for fractures compressing the spinal cord or nerve roots, and for injuries that would otherwise heal in an alignment that compromises function. The goal is to protect neurological function, restore alignment, and stabilize the injured segment so that rehabilitation can begin, with the shortest construct that reliably achieves it.