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Dr. Paresh Bang
Consultant Spine Surgeon
Surgery for fracture spine In Akola
Surgery for fracture spine
Surgery for fracture spine vertebral fracture, also known as a spinal fracture, is a break or collapse in one or more of the bones that form the spine, referred to as vertebrae, due to trauma or any other underlying conditions. The extent of the fracture can vary from minor in which the bone cracks to the more serious manner where the bone shatters. Sometimes, spinal fractures can be life-altering, especially in those who affect their spinal cord, thus causing a certain level of paralysis. Compression fracture A type of vertebral fracture where the bone collapses due to trauma or weakened bone density.
Types of spinal fractures
Spinal fractures are classified based on the mechanism of injury and the specific region of the spine affected. The three main types of spinal fractures are:
Compression Fracture
Description: This is the most common type of vertebral fracture, where the front part of the vertebra collapses. The back part remains intact, forming a wedge shape.
Causes: Often caused by osteoporosis, but also can occur from trauma (e.g., falls, car accidents).
Symptoms: Mild to severe back pain, especially when standing or walking. In cases of multiple compression fractures, a hunched posture (kyphosis) may develop.
Burst Fracture
Description: In a burst fracture, the vertebra is severely compressed, causing it to shatter into multiple pieces. This can result in bone fragments spreading into the spinal canal and compressing the spinal cord or nerves.
Causes: High-energy trauma such as a car accident or a fall from a height.
Symptoms: Severe back pain, neurological symptoms like numbness or weakness in the limbs if the spinal cord is compressed.
Flexion-Distraction Fracture (Chance Fracture)
Description: This fracture occurs when the spine bends too far forward, causing the vertebrae to pull apart. It commonly affects the thoracic or lumbar spine.
Causes: Often the result of a violent forward motion, such as in a car crash where the seatbelt restrains the pelvis while the upper body moves forward.
Symptoms: Back pain, potential injury to abdominal organs (since these fractures often occur with seatbelt injuries).
Fracture-Dislocation
Description: A combination of a fracture and a dislocation, where the vertebra breaks and moves out of alignment with the rest of the spine. This type of injury often leads to spinal instability.
Causes: High-energy trauma such as falls, vehicle accidents, or violent sports injuries.
Symptoms: Severe pain, neurological damage, and possibly paralysis if the spinal cord is involved.
How the Procedure Works:
Spinal fusion essentially “welds” together the problematic vertebrae so they heal into a single, solid bone, stopping movement between them and stabilizing the spine. Here’s an overview of how a surgery is performed:
- Bone Graft Placement: The surgeon uses a bone graft to stimulate bone growth between the vertebrae that need to be fused. Bone grafts can come from:
- The patient’s own body (autograft)
- A donor (allograft)
- Synthetic bone graft substitutes
- Instrumentation: To help the vertebrae fuse together, hardware such as metal rods, screws, or plates are used to hold the vertebrae in place while the graft heals.
- Surgical Approach: The surgeon may access the spine from:
- The front (anterior approach), through the abdomen.
- The back (posterior approach), through the muscles around the spine.
- The side (lateral approach), depending on the condition being treated.
Regions of the Spine Affected
Cervical Spine (Neck): Fractures in the neck region are the most dangerous because they may affect breathing and motor control. Common fractures include the C1 (atlas) and C2 (axis), known as Jefferson and Hangman’s fractures respectively.
Thoracic Spine (Upper/Mid Back): Fractures in the thoracic spine are often the result of high-energy trauma. This area is more stable due to the ribcage, so fractures are less common but can still result in serious consequences.
Lumbar Spine (Lower Back): Lumbar fractures are common because this region bears a lot of the body’s weight and is highly mobile. These fractures can lead to severe pain and mobility issues.
Causes of Spinal Fractures
Trauma: Motor vehicle accidents, falls from a height, sports injuries, and violent incidents.
Osteoporosis: This condition weakens the bones, making them more susceptible to fractures, especially in the elderly. The vertebrae become brittle and can fracture even from minor stress, such as a fall or even lifting a heavy object.
Tumors: Cancer can weaken the bones of spine, leading to fractures called pathological fractures. Tumors that start in the spine or metastasize to the spine can be a cause.
Infections: In rare cases, infections like osteomyelitis can weaken the spine and lead to fractures.
Symptoms of a Spinal Fracture
Pain: The most common symptom, usually sharp and localized at the site of the fracture.
Numbness, tingling, or weakness: If the fracture compresses the spinal cord or nerves, neurological symptoms like numbness, weakness, or even paralysis may occur.
Kyphosis (hunched posture): Especially common in compression fractures.
Loss of bladder or bowel control: A sign of severe spinal cord injury.
Diagnosis
Physical Examination: The doctor will check for tenderness, deformity, and neurological function (sensation, strength, reflexes).
Imaging Tests:
X-rays: Show fractures and misalignment of the vertebrae.
CT scans: Provide more detail about the bone injury.
MRI: Shows soft tissue, including the spinal cord, nerves, and any herniated discs or bone fragments.
Treatment Options
- Treatment depends on the severity of the fracture, stability of the spine, and whether or not the spinal cord is involved.
a. Conservative Treatment (Non-Surgical) - Bracing: A brace may be prescribed to immobilize the spine while it heals.
- Pain Medication: To manage pain during the healing process.
- Rest: Limiting movement to allow healing.
- Physical Therapy: Once initial healing has occurred, therapy can help restore strength and mobility.
b. Surgical Treatment - Surgery is considered when:
- The fracture causes instability in the spine.
- There is compression of spinal cord to nerves.
- The fracture is not healing with conservative treatments.
Spinal Fusion: - To stabilize the spine.
- Vertebroplasty/Kyphoplasty: To treat compression fractures.
- Decompression Surgery: To relieve pressure the spinal cord or nerves.
- Open Reduction and Internal Fixation (ORIF): To realign the bones and hold them in place with screws, rods, or plates.
Complications of Spinal Fractures
Spinal Cord Injury: Can lead to paralysis or neurological deficits.
Chronic Pain: Some patients may experience long-term pain after healing.
Kyphosis: Multiple compression fractures can lead to a hunched posture.
Osteoarthritis: Degeneration of the spine can occur over time.
Recovery and Rehabilitation
Recovery from a spinal fracture depends on the type of fracture and the treatment provided. Patients who undergo conservative treatment typically heal within a few months, while those who have surgery may take longer. Rehabilitation, including physical therapy, is crucial to regaining strength, flexibility, and overall function. Long-term follow-up care is often needed to monitor for complications such as spinal deformities or instability.
Prevention
Bone Health: Maintain strong bones through adequate calcium and vitamin D intake, regular exercise, and addressing risk factors for osteoporosis.
Fall Prevention: Especially in older adults, reducing fall risk through home modifications, vision checks, and balance exercises can prevent fractures.
Safety Measures: Use seatbelts, and take precautions during sports and activities that pose a high risk of trauma.
Who is a Good Candidate for Laser Spine Surgery?
Laser spine surgery is generally recommended for patients with specific, localized soft tissue issues, such as:
- Herniated or bulging discs
- Mild to moderate spinal stenosis (narrowing of the spinal canal)
- Patients who have not responded to conservative treatments (e.g., physical therapy, medications, injections)
However, patients with more severe conditions, such as spinal instability, fractures, tumors, or multiple-level degenerative disc disease, are not good candidates for laser spine surgery. These conditions often require more comprehensive surgical intervention, such as spinal fusion or decompression surgery. Contact Us