Spinal traumas and fractures

A spinal fracture is when you break and/or dislocate any of the group of small bones in your back, known as vertebrae. Your spinal column is made up of 33 vertebrae, all of which protect the spinal cord, support the weight of your head and body, and allow flexible movement.

The severity and outcome of a fractured spine can vary significantly depending on the type of fracture, its location, and if any damage has been done to the spinal cord. Our specialist spinal team can often treat less severe cases without the need for surgery.

The significance of the spinal cord, which runs through the spinal canal of each vertebra, makes the potential consequences of any break or fracture serious. Your spinal cord is a long tube of tissue containing nerves and cells and is primarily responsible for your motor function (how you move, sense and react). 

It connects your brain to your lower back through the nervous system. A vertebral fracture or dislocation can pinch, compress and even tear your spinal cord and nerves, so it’s important to always seek expert medical attention for a spinal fracture as soon as possible.

Anyone can suffer a fractured spine, just like any other bone fracture or break. They're most commonly caused by traumatic events such as traffic collisions,  and falls from a height. Dislocations can be independent of, or connected to, fractures and occur when the discs or ligaments connecting two vertebrae are torn or stretched.

You may be more at risk of a spinal fracture if you have a health condition that causes your bone density and strength to deteriorate. These include:

• Osteoporosis: This condition weakens your bones and makes them more likely to break or fracture. Older adults are more likely to develop osteoporosis as they age, but it can impact younger people too.
• Cancer and spinal tumours: Spinal cancer or a cancer that has spread to the area from another part of the body (known as metastatic cancer) can contribute to vertebral fractures. As tumours grow, they often put pressure on the spinal cord, increasing the risk of fractures. This is also the case with non-cancerous (benign) spinal tumours.

The most common types of spinal fractures are:

• Compression fractures: Small cracks and deterioration of the vertebrae can lead to collapse under sustained compression over time. This impacts the front of the vertebrae more than the back, often creating a hunched posture and reducing your height. This type of spinal fracture is most common in people with osteoporosis but can occur as a result of tumours.
• Burst fractures: These injuries are more sudden and usually happen when your spine is compressed under significant weight or force. This often leads to your vertebrae breaking into pieces and in multiple directions, increasing the chances of spinal cord damage. This is typically a more severe and debilitating spinal fracture, commonly arising from traffic collisions and sports injuries.
• Chance (distraction) fractures: Like a burst injury, a chance fracture also occurs suddenly but when extreme forces pull vertebrae away from each other rather than compressing them. These are sometimes referred to as ‘seatbelt fractures’ because the rapid deceleration in a car crash can cause your spine to flex beyond its limits.

Fractures are also assessed on whether they are ‘stable’ or ‘unstable’. A stable fracture is less serious because the structure of your spinal column hasn't been fundamentally changed, despite a fracture somewhere along the vertebrae. You'll still need treatment, but the need for spinal surgery is less likely.

An unstable fracture carries greater risk because the vertebrae has been dislodged from its natural alignment and poses a greater threat to your spinal cord and the structure of your backbone. Spinal surgery is more likely to be needed for an unstable fracture because the damage is more severe and the ongoing risks of nerve damage and paralysis are higher.

Spinal trauma and fracture symptoms can depend on the type, severity and location of your injury. For example, you might not notice that you have a compression fracture, as these develop gradually over time.  

The symptoms associated with burst and chance fractures are usually more serious and quicker to develop. You may experience any of the following fractured spine symptoms:

• Intense back or neck pain, often worsening with movement
• Swelling, usually of the area around the fractured vertebra, which becomes painful to touch
• Tingling and numbness in your back, but sometimes running down your arms or legs
• Weakness and paralysis of limbs without any other explanation
• Changes to your natural posture, which worsen over time
• Height loss (you may become noticeably shorter over time)
• Incontinence (losing control of your bladder or bowels)

When you meet with your chosen spinal consultant, you'll be asked to share your symptoms and discuss any changes you've noticed in your posture, strength or mobility. Your consultant will also ask you about any pain or nerve damage symptoms you're experiencing. 

If you have osteoporosis or recently experienced trauma (for example, in a car accident), this information will help the consultant get a better sense of the cause of your spinal fracture pain. If you were taken into emergency care after a traumatic accident, a fractured spine may have been diagnosed by medical staff at the time.

Your consultant will carry out a physical examination of your back and refer you for any imaging tests, if necessary, to confirm a spinal fracture. 

At HCA UK, the imaging tests we commonly use to diagnose spinal fractures are X-rays, MRI scans and CT scans. We may also carry out a bone density (DEXA) scan if you're at risk of osteoporosis. 

One or a combination of these tests will allow your consultant to assess the severity and type of fracture you've suffered, before they recommend the most effective form of treatment.