TREATMENT OF FRACTURED VERTEBRAE
Symptoms | Causes | Diagnosis | Conservative treatment | Surgical treatment | Post-operative treatment | Consultations & second opinions
Vertebral fractures in the thoracic or lumbar spine due to accidents can result in vertebral instability and potential neurological issues. In the long term, injuries to the vertebrae can also result in excessive curvature of the spine. This curvature may be the reason for misalignment of the spine and can explain why people with vertebral fractures often suffer from post-traumatic chronic back pain.
Surgical treatment of these fractures is recommended in certain cases to restore vertebral height, correct curvature and treat neurologically affected areas.
Pain in the area of the affected vertebrae is a common symptom of a fracture in the spine.
After an accident or injury
People with an acute fracture report sudden pain when changing posture or position, coughing, sneezing or lifting. Occasionally there is curvature and tenderness along the midline of the spine.
Chronic (old) vertebral fractures
Chronic fractures can be associated with a loss of height and curvature of the spine. In addition to the vertebral fracture, it may be that osteoporosis, muscle weakness, pressure ulcers, ileus, urinary retention, limited respiratory function, venous thromboembolism or spinal cord compression with corresponding neurological deficits are also diagnosed.
Common causes of fractured vertebrae in the thoracic or lumbar spine include direct injury, genetic causes, inherited bone disease, osteoporosis or tumours.
A neurological evaluation is performed during the physical examination. Compression fractures caused by excess pressure are usually diagnosed through lateral x-rays of the spine.
The specialist uses magnetic resonance imaging (MRI) or a computed tomography (CT) scan to determine the type and shape of the fracture. A CT scan or MRI will also be considered for individuals whose condition does not improve after conservative treatment and in people with progressive symptoms.
An MRI is essential to determine the appropriate treatment of the spinal fracture. In rare cases, blood/laboratory testing is also required.
Conservative treatment is aimed at relieving pain, restoring function and preventing future fractures. Typically, conservative treatment consists of a combination of immobilisation with a back brace (back support or spinal orthosis) for 3 months, patient-specific pain relief therapy and medication to treat osteoporosis.
In most cases, prolonged bed rest is required (26 days for the lumbar spine, 13 days for the thoracic spine) and then a reduced level of physical activity for 3 to 6 months.
Minimally invasive surgery is possible in most cases. This technique is usually associated with less blood loss during the surgery, less pain after the procedure, a shorter hospital stay and easier healing.
In order to achieve good stability and optimal pain reduction, it is usually sufficient to perform a reinforcement procedure in which small cannulas are inserted through the vertebral arch through a skin incision of less than four millimetres. With the help of intraoperative X-ray imaging, the cannulas are used to insert either only cement, in a procedure which is also called vertebroplasty, or cement together with a stent (internal support system).
If the fracture causes a high level of instability, it is necessary to stabilise the fracture segments with a system of screws and rods.
Regular check-ups (X-rays or CT scans) are needed to assess the position of the implant and the load-bearing capacity of the spine.
Wound pain and back pain after the procedure can be uncomfortable, but can be easily treated with painkillers.
The post-operative healing process is very individual and depends on various factors such as the diagnosis, the person’s age and their general health.
Cav.Dr. med. (I) Alessandro Rustia has many years of experience and a high level of expertise in spinal surgery and pain therapy. We ensure rapid, expert assessment and treatment in line with the latest medical findings. Don’t hesitate to get in touch if you would like a second opinion.
Because the Pyramid Clinic is a private clinic, patients here require supplementary insurance. You will therefore need private or semi-private insurance for your treatment. If you have general insurance you can also be treated here if you opt to pay for an upgrade.