The severity of spinal fractures can vary greatly. Some fractures are extremely serious wounds brought on by high-energy trauma and call for immediate medical attention. In an older person with osteoporosis-weakened bones, other fractures may occur as a result of a less severe incident, like a minor fall.
The majority of spinal fractures happen in the thoracic (midback) and lumbar (lower back) spines or where they meet (thoracolumbar junction). A fall from a height or a serious blunt trauma, such as a car accident, frequently results in lumbar spine fractures. Osteoporotic fractures and pathological fractures are non-traumatic causes.
The course of treatment is determined by the degree of the fracture and any additional injuries the patient may have. You can better understand spinal fractures if you are aware of how your spine functions.
Anatomy of Lumbar
As the name implies, lumbar spine fractures always occur in the lumbar region. The lower back region of the spine known as the lumbar spine is a typical painful area in physical therapy. It is distinguished by lordosis and is located between the thoracic and sacral regions of the spine.
Five vertebrae make up the lumbar spine, and they are both sturdy and articularly flexible, enabling the body to move in a variety of planes, including flexion-extension, rotation, and lateral flexion. A lumbar vertebra consists of;
- A large anterior body that bears the majority of the weight placed on the spine.
- Massive dorsal vertebral arches that protect the neural structures (spinal cord) that lie within the vertebral foramen (space between the body and the arches).
- Various processes to which many muscles and ligaments attach.
- Other weight-bearing structures include the pedicle and facet joints.
Intervertebral discs, which are located between the vertebrae, support the vertebral bodies’ ability to bear weight and serve as shock absorbers. These discs also serve the purpose of joining the vertebral bodies together.
Cause of lumbar spine fracture
High-energy trauma, such as the following, can lead to thoracic and lumbar spine fractures:
- Collision involving a car and a motorcycle
- Fall from a considerable height
- Athletic mishap
- Violent deed, like a gunshot wound
Frequently, these patients have additional, serious injuries that need immediate care. Depending on the extent of the fracture, the spinal cord and/or nerves may also sustain damage.
Bone insufficiency can also lead to spinal fractures. For instance, people who have osteoporosis, tumors, or other underlying diseases that weaken the bone can fracture a vertebra even during less severe events, like reaching, twisting, or falling from a standing position. Without any symptoms or discomfort until a bone breaks, these fractures may develop slowly over time without being noticed.
Types of lumbar spine fracture
Spinal fractures come in various forms. Based on the specific pattern of the fracture and whether there is a spinal cord injury, doctors categorize fractures of the thoracic and lumbar spine. Your doctor can decide on the best course of action by categorizing the fracture pattern. The three major types of spine fracture patterns are:
- Flexion
- Extension
- Rotation
Flexion Fracture Pattern
Compression fracture
The back (posterior) of the vertebra does not break or lose height, but the front (anterior) does. This kind of fracture is typically stable (the bones have not moved out of place), and neurologic issues are rarely linked to it. Patients with osteoporosis frequently experience compression fractures.
Axial burst fracture
The vertebra loses height on both the front and back sides of the fracture. It frequently results from landing on the feet after a significant fall. Nerve compression can occasionally happen as a result of an axial burst fracture. While some fractures are significantly unstable, others are stable.
Extension Fracture Pattern
Flexion/distraction (Chance) fracture
The vertebra is yanked apart literally (distraction). When the upper body is thrown forward in a head-on collision and the pelvis is restrained by a lap seat belt, this kind of fracture can happen. This fracture is usually unstable.
Rotation Fracture Pattern
Transverse process fracture
Rotation or extreme sideways (lateral) bending cause this rare fracture. Typically, it has no impact on stability.
Fracture-dislocation
This injury involves soft tissue and/or bone and occurs when a vertebra slides off of an adjacent vertebra (displacement). Frequently, these wounds result in severe spinal cord compression.
Symptoms of lumbar spine fracture
Back pain from a thoracic or lumbar spine fracture ranges from mild to severe, and it gets worse when you move. If the spinal cord or nerves are affected, the patient may also experience numbness, tingling, or weakness in the limbs in addition to bowel/bladder dysfunction.
If high-energy trauma caused the fracture, the patient may also suffer a brain injury and “black out,” or lose consciousness. Other injuries, referred to as distracting injuries, may also result in pain that outweighs back pain. In these situations, especially following a high-energy event like a car accident, it must be assumed that the patient has a spine fracture.
Diagnosis of lumbar spine fracture
A radiologic evaluation is required following the physical examination. Depending on the severity of the injuries, x-rays, computerized tomography (CT) scans, and magnetic resonance imaging (MRI) scans of multiple areas, including the thoracic and lumbar spine, may be performed.
Treatment
Treatment of Flexion Fracture Pattern
Nonsurgical treatment
Bracing can be used to treat most flexion injuries, including stable burst fractures and osteoporotic compression fractures, for 6 to 12 weeks. Most patients avoid post-injury problems by gradually increasing physical activity and performing rehabilitation exercises.
Surgical treatment
Surgery is usually required for unstable burst fractures that have the following characteristics:
- Significant reduction (multiple bone fragments).
- Significant loss of vertebral body height.
- Excessive forward bending or angulation at the site of the injury.
- Significant nerve injury caused by vertebral body or disc parts pinching the spinal cord.
- Ligament damage causes the spine to be unstable.
Treatment of Extension Fracture Pattern
Nonsurgical treatment
Extension fractures that only penetrate the vertebral body can frequently be treated conservatively. The patient should be fitted with a brace or cast for 12 weeks while these fractures are closely monitored.
Surgical treatment
If the posterior (back) ligaments of the spine are injured, surgery is frequently required. Additionally, surgery should be done to stabilise the fracture if it passes through the spinal discs.
Treatment of Rotation Fracture Pattern
Nonsurgical treatment
Transverse process fractures are typically treated with a gradual increase in motion, with or without bracing, depending on patient comfort.
Surgical treatment
Very high-energy trauma causes thoracic and lumbar spine fracture-dislocations. They can be extremely unstable injuries with serious spinal cord or nerve damage. These injuries necessitate surgical stabilization. The best time for surgery is often difficult to determine. Other serious, life-threatening injuries may cause surgery to be postponed.
Complications in lumbar spine fracture
- Blood clots in the pelvis and legs
- Pulmonary embolism
- Pneumonia
- Pressure sores
There are also specific complications associated with spinal surgery. These include:
- Bleeding
- Infection
- Spinal fluid leaks
- Instrument failure
- Nonunion
- Wound complications
In a nutshell
The implant used in lumbar spine fracture determines the success of the surgery. As a result, Zealmax Ortho manufactures and distributes the most dependable orthopedic implants, which have a high success rate and are widely used in surgery around the world. We offer a diverse range of bone implants at competitive prices without sacrificing quality.
