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Dr. Paresh Bang
Consultant Spine Surgeon
Surgery for fracture spine In Yavatmal
Surgery for fracture spine
Types of spinal fractures
A healthcare provider will classify the fracture in your spine based on where it is in your back and how your vertebrae are broken. They’ll also classify the fracture as stable or unstable, depending on whether your vertebrae are out of their usual alignment.
Segments of the spine
Your spine is divided into three main sections, all of which can experience a spinal fracture:
- Cervical spine fracture: Broken vertebrae in your neck.
- Thoracic spine fracture: Broken vertebrae in your upper back that runs from the bottom of your neck to the bottom of your ribs.
Lumbar spine fracture: Broken vertebrae in your lower back.
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.
What are the symptoms of a spinal fracture?
If you do experience symptoms, they will include the following:
- Back pain: A sharp, intense pain in your back. Pain might also get increasingly worse over time, especially when you’re walking or moving.
- Swelling or tenderness: The area around the broken vertebrae may be swollen and painful to touch.
- Changes to your posture: A new slump or stoop in your spine that causes you to lean forward in ways you didn’t before.
- Tingling or numbness: A tingling or numb feeling in your back that might run down your arms or legs.
- Height loss: You might get noticeably shorter over time (sometimes up to 6 inches).
- Incontinence: A new loss of your ability to control your bladder or bowels.
What causes spinal fractures?
Fractured spine causes include:
- Osteoporosis: Osteoporosis makes your bones lose density and strength over time. This increased fragility increases your risk for many types of fractures.
- Trauma: Traumas put a lot of stress on your bones. Your spine is usually very flexible and moves with you. But, a sudden intense force like a car accident or a sports injury can exert more force than your spine can tolerate, which causes spinal fractures.
- Spinal tumors: Most spinal tumors result from cancer metastasis — cancer that has spread from another area of your body to your spine.
How are spinal fractures diagnosed?
Your healthcare provider will diagnose a spinal fracture with a physical exam and imaging tests. They’ll look at your back, feel for any spots that are tender or painful and identify any changes to the shape of your spine and posture. Make sure to tell them exactly where you’re hurting and when you noticed any new pain or discomfort.
If you experience trauma, the fracture might be diagnosed by providers in the emergency room. They’ll diagnose your fracture and any other injuries after you’re stabilized.
How are spinal fractures treated?
Most spinal fractures don’t require surgery. The most common treatments include:
- Bracing: You might need to wear a back brace to hold your spine in alignment and help your broken vertebrae heal properly. Most people need to wear a brace for a few months. Your provider will talk to you about which type of brace you’ll need and how long you’ll need to wear it.
- Physical therapy: Strengthening the muscles in your back can improve your overall strength, help reduce bone loss and reduce the risk of future spinal fractures. You might need to work with a physical therapist in person or do at-home exercises.
- Treating osteoporosis: If you have osteoporosis, your provider might prescribe medicine or over-the-counter (OTC) supplements to help strengthen your bones to prevent future fractures.
If you experience trauma, providers in the emergency room will treat your injuries in the order of severity, especially if some of them are life-threatening.
Spinal fracture surgery
If the spinal fracture is in danger of damaging your spinal cord, or if your pain doesn’t improve a few months after non-surgical treatments, you might need surgery. The most common surgeries to repair fractures are vertebroplasty and kyphoplasty.
Vertebroplasty: Your surgeon injects liquid cement into your fractured vertebrae to strengthen it.
Kyphoplasty: Kyphoplasty is similar to vertebroplasty, but before your surgeon injects the liquid cement into your vertebrae, they insert a tiny balloon into them. When they inflate the balloon, it pushes your bones back into their correct place and re-creates the space that was originally there before your fracture.
Types of Spinal Fractures:
- Compression Fracture: Common in individuals with osteoporosis, these occur when the vertebra collapses, typically due to a minor trauma or even spontaneously.
- Burst Fracture: Caused by severe trauma, such as a car accident or a fall from height, where the vertebra is shattered into multiple fragments, often leading to spinal cord injury.
- Flexion-Distraction Fracture (Chance Fracture): Occurs when the spine is forced to bend forward too far, typically in car accidents with seatbelts. It can cause damage to both bone and ligaments.
- Fracture-Dislocation: A severe injury where the vertebra fractures and moves out of alignment. This usually results in significant damage to the spinal cord or nerves.
Indications for Surgery:
Not all spinal fractures require surgery. Conservative treatments like bracing and rest may be effective for stable fractures, but surgery is considered in the following situations:
- Spinal Instability: If the fracture makes the spine unstable and unable to support body weight or movement without risk of further damage.
- Spinal Cord or Nerve Compression: When a fracture causes compression of the spinal cord or nerve roots, leading to symptoms like weakness, numbness, paralysis, or loss of bladder/bowel control.
- Severe Pain: Persistent, debilitating pain that does not respond to non-surgical treatments.
- Failed Conservative Treatment: If non-surgical treatments, such as bracing and physical therapy, do not result in healing or stabilization.
Surgical Procedures for Spinal Fractures:
- Vertebroplasty and Kyphoplasty (for Compression Fractures):
- Purpose: Minimally invasive procedures to stabilize compression fractures caused by osteoporosis and tumors.
- Procedure:
- Vertebroplasty: A special bone cement is injected into the fractured vertebra to stabilize the fracture.
- Kyphoplasty: Similar to vertebroplasty, but a balloon is inserted first to restore height to the collapsed vertebra before cement is injected.
- Recovery: Typically the quick recovery, often performed on a outpatient basis. Pain relief is usually immediate.
- Spinal Fusion (for Severe or Unstable Fractures):
- Purpose: Fuses two or more vertebrae together to provide long-term stability and prevent movement at the fracture site.
- Procedure:
- Bone grafts (from the patient’s body or a donor) are placed between the affected vertebrae.
- Metal rods, screws, and plates are used to hold the vertebrae in place while they fuse together.
- Spinal fusion can be done from the front (anterior fusion) and back (posterior fusion), depending on the location of the fracture.
- Recovery: Fusion is a major surgery with a recovery time of several months. Patients will need physical therapy and activity modifications during recovery.
- Laminectomy:
- Purpose: Removes part of the vertebra (lamina) to relieve pressure on the spinal cord or nerves caused by fractured bone fragments or swelling.
- Procedure: The lamina (the back part of the vertebra) is removed to create more space and decompress the spinal cord or nerves. This may be done with or without fusion, depending on the stability of the spine.
- Recovery: Recovery time varies depending on the extent of the surgery and whether fusion is involved.
- Instrumentation (Internal Fixation):
- Purpose: Metal screws, rods, or plates are placed to stabilize the spine and keep the fractured vertebrae in proper alignment during healing.
- Procedure: Surgeons place metal hardware to stabilize the spine, often used alongside spinal fusion to ensure proper healing.
- Recovery: Similar to fusion surgery, recovery can take several months, with physical therapy needed to regain strength and flexibility.
- Corpectomy:
- Purpose: Removes part or all of a fractured vertebra to relieve spinal cord compression and provide stabilization.
- Procedure: The surgeon removes the damaged vertebra and replaces it with a bone graft or metal cage. Plates and screws are then used to stabilize the spine.
- Recovery: Recovery from a corpectomy can take several months, and rehabilitation is essential.
Recovery After Spinal Fracture Surgery:
- Hospital Stay: Depending on the complexity of the surgery, patients may stay in the hospital for a few days to a week.
- Pain Management: Pain medication is provided during the recovery process to help manage discomfort.
- Physical Therapy: Rehabilitation typically begins a few weeks after surgery and is vital for regaining strength, mobility, and flexibility. Physical therapy programs are tailored to the individual’s condition and surgical procedure.
- Brace Use: In some cases, patients may need to wear a brace for several weeks to provide extra support while the spine heals.
- Activity Restrictions: Patients are advised to avoid heavy lifting, bending, twisting, and other activities that place stress on the spine for a few months. Return to normal activities depends on the type of surgery and the patient’s overall condition.
- Full Recovery: Full recovery can take several months. For more invasive surgeries like spinal fusion, healing may take 6-12 months.
Risks and Complications:
Surgery for a fractured spine, like any surgery, carries certain risks, including:
- Infection: Any surgery comes with a risk of infection, which can be treated with antibiotics or, in severe cases, additional surgery.
- Nerve Damage: There is a risk of damaging nerves or the spinal cord during the surgery, leading to numbness, weakness, or paralysis.
- Blood Clots: Prolonged immobility after surgery increases the risk of blood clots in the legs or lungs.
- Non-Union: In fusion surgeries, the bones may not fuse properly, which can require additional surgery.
- Implant Failure: If rods, screws, or plates are used, there is a small risk of hardware failure, leading to pain or instability.
Benefits of Surgery:
- Pain Relief: Surgery can provide significant relief from pain caused by the fracture.
- Stability: Surgical stabilization of the spine prevents further injury and promotes healing.
- Prevention of Neurological Damage: Surgery can prevent or reduce the risk of permanent neurological damage by relieving pressure on the spinal cord or nerves.
- Improved Function: Many patients experience improved mobility and function after healing from spinal fracture surgery.Contact Us