Spinal Fractures: Types and Symptoms
This article reviews four specific types of spinal fracture, starting with the most common type of spinal fracture – compression fracture.
- Compression fracture
- Burst fracture
- Flexion-distraction fracture
- Fracture-dislocation fracture
Compression Fracture
A compression fracture, or vertebral compression fracture, occurs when the vertebral body is crushed or compressed. The compressive force(s) may cause the vertebral body to crack, collapse and / or become wedge-shaped. These fractures can occur in the cervical (neck), thoracic, (mid back), or lumbar spine (low back).
Causes of Compression Fracture:
- Osteoporosis is a leading cause of vertebral compression fracture.1 Osteoporosis causes bone to become porous, weak, and highly susceptible to fracture.
- Trauma, crushing forces from a head-on collision or fall from a great height.
- Cancerous tumor that has spread (i.e. from the breast or prostate).
- Osteomyelitis is a bone infection caused by a bacterium.
Symptoms Related to Compression Fracture:
- Sudden onset of pain; often at the fracture level
- Pain is aggravated with movement and may ease when resting
- Pain that travels into or down the arms or legs
- Deep pain accompanied by muscle spasms
- Bowel or bladder problems
- Loss of height; especially with multiple compression fractures
- Posture change; a hump develops in the upper back (hunchback)
Burst Fracture
Burst fractures can be caused by severe trauma, such as from a car accident or significant fall. The severity of a burst fracture is measured in part by whether the vertebral body, or other parts of the bony vertebral structure, is significantly compressed or breaks into fragments. A burst fracture may cause the front and middle portions of the vertebral body to break.2 The bony fragments may be stable or be displaced. Sometimes, a burst fracture has the potential to cause spinal cord or nerve injury.
A vertebral body is divided into 3 sections: posterior (rear), middle, and anterior (front).
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Flexion-distraction Fracture
This type of fracture, sometimes called a Chance fracture, usually affects the thoracic (mid back) and / or lumbar (low back) vertebrae. A car accident or other trauma that suddenly and forcefully pushes the body forward (flexion), while the pelvis is stable,3 may cause a vertebral body to distract – or separate and break into pieces. This type of fracture usually involves all three sections of the vertebral column (posterior, middle, anterior). Most of these fractures are unstable and therefore require urgent medical care to immediately stabilize the spine to help avoid or reduce spinal cord and nerve injury.
Fracture-dislocation
A fracture-dislocation is an unstable injury involving a vertebra and / or ligaments, tendons, blood vessels, and other soft tissues. It can cause vertebral displacement.3 Displacement means that the vertebra is moved out of its original place.
Symptoms
Symptoms common to a burst fracture, flexion-distraction fracture, or fracture-dislocation are summarized in the table below.
| Symptom |
Burst |
Flexion-distraction |
Fracture-dislocation |
| Pain, especially at the fracture level |
X |
X |
X |
| Pain that travels down the arms / legs |
X |
|
X |
| Weakness, numbness, tingling below the fracture level |
X |
X |
X |
| Difficult walking, moving |
X |
X |
X |
| Bowel / bladder problems |
X |
X |
X |
| Paralysis |
X |
|
X |
Fracture Awareness and Medical Care
If you experience sudden neck or back pain, whether it is associated with trauma or not, it is a good idea to promptly contact your doctor for evaluation. Often, all that is needed to rule out spinal fracture is a simple x-ray.
As with any medical condition, there are red flag symptoms that serve to alert you to obtain immediate care. In the case of a spinal problem, red flags include bowel or bladder problems, incapacitating pain, and paralysis. If you suspect spinal fracture – contact your doctor. Your doctor has many new and minimally invasive treatment options available to treat spinal fracture.
References
1. Fast Facts on Osteoporosis. National Osteoporosis Foundation. Accessed February 17, 2009.
2. Schnuerer AP, Gallego J. Basic Anatomy and Pathology of the Spine. Medtronic Sofamor Danek. 2003.
3. Fracture of the Thoracic and Lumbar Spine. American Academy of Orthopaedic Surgeons. Accessed February 17, 2009.
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