A thoracic or lumbar fracture of the spine is a serious condition.
There are twelve vertebrae (blocks of bone) in the thoracic (chest) region at the back. They form attachment for the ribs of the chest.
The lumbar spine is made up of 5 vertebrae in the lower back that supports the body’s weight.
Types of Spinal Fractures
Fractures are categorised according to the patterns seen on imaging. These can help decide what treatment you will need.
Some of the types of fractures in the thoracic and lumbar region include:
- compression fracture
- axial burst fracture
- chance (extension) fracture
- transverse process fracture
- fracture dislocation
Symptoms
- Pain in upper back and neck that is worse with movement.
- Numbness and tingling sensations.
- Weakness of the arms and back.
- Problems with the bladder and bowel.
- Loss of consciousness (black-outs)
Causes
Any fracture may occur under direct force to the bone or if you stretch, bend or turn excessively.
Some scenarios that cause fractures in the thoracic and lumbar region include:
- High-impact accidents – car accidents, high-impact sports, fights.
- Fall onto a hard surface.
Less commonly,
- Conditions involving weak bone, such as tumours.
Risk Factors
- Activities that increase the risk of heavy impact to the back such as high-velocity sports.
- Osteoporosis in the elderly.
- Long-term steriod use causing weaken bones.
- A history of cancer.
- A history of infection in the back area.
Investigations
Immediately after the injury:
It is important never to move a person with a spinal injury until a doctor has seen him or her. Call the ambulance immediately.
History and Examination
The doctor will want to know exactly what happened to cause the injury. It is important that a witness of the accident or event be present to describe the event. The doctor will also perform a thorough examination to ascertain the severity of the injury and if anywhere else in your body is hurt.
Imaging
This is crucial in determining where is the fracture and what should be done about it.
The doctor will request one or more of the following investigations:
- Xrays
- CT
- MRI
Complications
Spinal fractures can cause devastating consequences or mild changes depending on the mode and severity of injury.
Fractures especially caused by high energy impacts can leave a person without function of the muscles and nerves below it, that often cannot be recovered. High impact accidents usually cause other injuries to the rest of the body that increases the number of complications.
In certain cases where the fracture is caused by brittle bones (osteoporosis) or infection or tumour, function can regain if the cause is treated but residual weakness and deformity can often be the case.
Treatment
The main goals of treatment are to restore stability of the spine and the function of the nerves as much as possible. This can be achieved by two ways:
Non-surgical
A brace can be worn around the back and chest for support as the injury heals. You will still be able to walk and move around and pain can be controlled by analgesic medications (pain killers).
Treatment goals include protecting nerve function and restoring alignment and stability of the spine. The doctor determines the best treatment method based upon fracture type and other factors.
Surgical
Often if the spine is found to be unstable, screws and metal plates will need to be inserted around the spine to prevent further injuries.
Seeking Advice
Your Family Doctor (GP)
Your Family Doctor will be able to diagnose and help treat your problem. He or she will be able to
- tell you about your problem
- advise you of the best treatment methods
- prescribe you medications
- and if necessary, refer you to Specialists (Consultants) for further treatment
Prevention
- Wear protective gear in high impact sports.
- Drive safely and carefully.
- Avoid fights.
- Ensure the health of your bones – ask your family doctor to check for osteoporosis and take calcium supplements if necessary.