Treatment of Spinal Fractures

By Mudit Sharma, MD

Virginia Spine Specialists

. http://www.virginiaspinespecialists.com/

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Treatment of Spinal Fractures

It is often a scary and confusing diagnosis if you or someone you know has been diagnosed with a spinal fracture. In this article, we look at common types of spinal fractures and their treatments.

One of the most common spinal fractures is a compression fracture of the spinal column. This occurs in the vertebrae of the spine and can happen with a sudden force or fall. It is most commonly seen in patients with low bone density (osteoporosis).

A large majority of these fractures heal on their own with the help of a back brace and bed rest with appropriate treatment of the underlying osteoporosis. Other reasons for such fractures can be trauma or tumors. If there is a suspicion of a tumor, your spine specialist may perform a bone biopsy to examine pathology of the fracture.

In some cases of compression fractures, the patients are in so much pain that they have to be hospitalized for pain control. After obtaining appropriate diagnostic tests (CT, MRI, x-rays, bone scans), the spine specialist may put some cement in the fractured bone to help speed up recovery (in a procedure called vertebroplasty) or restore the wedged fracture with a balloon and then put cement in it (kyphoplasty).

Another type of spinal fracture that is frequently seen in victims of automobile crashes is called a burst fracture. These fractures typically involve destruction of many aspects of the spinal column and can be unstable if left untreated. Depending on the patient's symptoms and diagnostic studies, these fractures may need surgery. The goal of an operation in this setting is to stabilize the spine and to relieve pressure on the spinal canal and nerve roots. There are now minimally invasive techniques that are used to stabilize these fractures that result in a quick patient recovery, minimal loss of blood during the surgery, and remarkably less pain.

Various types of cancers carry a risk of spreading to the spine and causing a fracture. These types of fractures are referred to as pathologic fractures. Depending on the type of fracture and the source of the cancer cells, the treatment for these can range from non-operative treatment to complete removal of the cancer through surgery.

Again, minimally invasive techniques have been very useful in this setting. By reducing the dissection of soft tissue needed to stabilize the fracture and entering through a smaller incision, minimally invasive techniques decrease the recovery time dramatically. This is important because this allows the patients to start chemo or radiation therapy quickly.

There are some types of cancers that are very sensitive to radiation and respond quickly to it. These remain a good target for radiation treatment even when they spread to the spine. In those cases, a biopsy may be sufficient to establish the proper diagnosis and appropriate treatment. Again, if a surgery is needed, the minimally invasive approach achieves all of the above objectives with minimal disruption of patient's life.