Vertebral Compression Fractures
The spine is a robust combination of 24 vertebrae that protect the spinal cord. The intervertebral discs and ligaments connect the vertebrae.
The vertebrae are shaped like arches and carry bony extensions on the sides and on the back. This structure protects the spinal cord and provides lateral exit points for the spinal nerves.
Mild cases can be treated conservatively; however, some instances require complex surgical intervention to relieve symptoms.
In chronic cases, a patient’s spine is severely compromised and experiences intense, persistent pain. An early diagnosis is crucial to avoid permanent long-term consequences.
Types and Causes of Vertebral Fractures
There are broadly two types of vertebral fractures, including:
Stable Fracture:
Vertebral fractures are called stable if the surrounding soft tissues and ligaments are unaffected. There is also no narrowing of the spinal canal. Stable fractures are the most common vertebral fractures (around 85% of all spine fractures). Stable fractures are mostly treated conservatively.
Unstable fractures:
Unstable fractures are rarer and tend to be much more complicated. There is a chance of fragments of the vertebra being displaced and a complete severance of the vertebral arch. Patients with an unstable fracture are at a real risk of fragments protruding into the spinal canal and, in the worst-case scenario, puncturing and injuring the spinal cord. Unstable fractures require immediate treatment to prevent or at least limit permanent damage to the spinal cord.
Fractures caused by Osteoporosis of the spine:
Fractures caused by osteoporosis or bone density loss are a special case of spinal fractures. Leeching off the bones to maintain blood calcium levels can result in weak, brittle and porous bones. Osteoporosis can lead to fractures even under mild or relatively light loads on the back. The demineralised vertebra slumps or collapses at the front edge. As a result, it loses height and the ligaments surrounding it loosen, which in turn makes the affected segment unstable. If the front edges of several overlying thoracic vertebrae collapse, there is also excessive forward curvature of the thoracic spine (hyperkyphosis).
Fractures from osteoporosis can lead to permanent deformations and can cause complications like shortness of breath or irregular heart functioning.
The most commonly known causes for a vertebral fracture include:
- Accidental injury or trauma to the back can lead to a fracture in the vertebrae.
- A violent fall with direct impact on the spine. Additionally, certain hormonal diseases, like Osteoporosis, can lead to reduced bone density in the spine. This condition leaves the spine brittle and porous, increasing the risk of fractures.
Vertebral Compression Fractures Symptoms
The most commonly known symptoms associated with a vertebral fracture include:
- Immediate and intense localised pain.
- Severely restricted mobility of the spine forces patients to adopt a slumped posture to avoid stressing the spine.
- If the nerves or the spinal cord are affected as it is in an unstable fracture, there are often accompanying neurological symptoms such as paralysis, severe stabbing or burning pain and numbness.
- A patient experiences immense irritation, pain and discomfort. The surrounding area might get inflamed, and their mobility is severely restricted.
- Psychologically, a patient feels instability in their back, which can result in a severely debilitating effect on the quality of life.
Assessment of Vertebral Fractures
A complete medical history and physical examination allow a medical practitioner to gather valuable information about the patient and the associated risk factors.
Sophisticated imaging technology, such as X-rays, effectively determines the severity of the fracture and pinpoints its location. Ultrasound and MRI can also be used to check for accompanying complications, like damage to the spinal nerves or the spinal cord itself. An early diagnosis could be key to ensuring a swift recovery.
Treatment For Vertebral Compression Fractures
Immobilisation
Immobilising the back temporarily has proven effective in managing the symptoms of the condition. This allows the back to rest and prevents further damage. Patients should be careful not to prolong the immobilisation period since it can lead to muscle atrophy and aggravate the condition due to a loss of stability.
Rehabilitation, Physiotherapy And Occupational Therapy
Regulated occupational therapy is a proven effective treatment path for targeted muscle training. The physiotherapy exercises can help promote muscle reorganisation.
Encouraging healthy proprioception and strengthening the muscles in the back helps prevent long-term degeneration. Physiotherapy can effectively help regain coordination and mobility after a period of immobilisation.
Prescribed Painkillers
Painkillers such as Ibuprofen or Panadol can temporarily alleviate pain and discomfort in patients. In cases of inflammation in the back, anti-inflammatory medication is also recommended to improve the patient’s short-term quality of life.
Medical Back Braces
It is highly recommended that ample support to the back is provided using a medical back brace. Wearing a Bauerfeind back brace like the Spinova Support Plus can be instrumental in treatment, by providing enhanced stability, proprioception and medical-grade compression. This is not found in poorly designed or simple neoprene braces and has proven more effective.
Surgical Intervention
Surgical intervention is required only in rare cases of complications where conventional methods have failed or in advanced cases (unstable fractures) where damage has occurred to the connective soft tissue and the spinal cord itself. Doctors might necessitate surgery at a moment’s notice to prevent permanent damage to the spinal cord.
Today, surgeons can perform keyhole surgery with the smallest possible incision to refill stacked vertebrae using modern surgical procedures. This dramatically reduces recovery time and can be instrumental in preventing muscle breakdown due to long periods of bed rest or immobilisation.
Medical Back Orthosis: Pain Relief for Vertebral Fracture
LordoLoc Back Brace
Medical back orthoses like the Spinova Osteo and the LordoLoc Back Brace can be instrumental in both conservative and post-operative treatment. In the event of a lumbar spine fracture, an orthosis supports and stabilises the affected segment and thus prevents unwanted movements that would endanger the spine's stability.
The braces help alleviate pain, enabling you to stay active and allowing you to be comfortable standing and sitting in everyday life. A medical back brace allows for a more effective exercise and self-exercise program and can facilitate healing.
The Spinova Osteo shapes to your spine and unloads it with the help of corrective straps and a pelvic support. The LordoLoc provides comfort and stability through medical compression and supportive splints.