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fracture

Burst fractures of spinal vertebra are severe traumatic injuries often seen in high energy traumas, such as high speed collisions and falls from great heights. Extreme energy transferred to the spine may burst or crush a vertebra. In our practice we most often have seen severe burst fractures in clients hit hard from the rear by tractor trailers, as those are collisions involving extremely high kinetic energy.

In a burst fracture, shards of bone tissue from the vertebra penetrate surrounding tissues and sometimes the spinal canal. Severity of a burst fracture depends upon the "severity of deformity, degree of canal compromise, the loss of vertebral body height, and degree of neurologic deficit. Generally more serious than compression fractures, herniated discs and many other back injuries, burst fractures often cause long-term neurological damage.

Immediate hospitalization is always required in cases of burst fracture because of the potential for spinal cord damage including potential paralysis. Extensive radiological examination, including MRI (magnetic resonance imaging), CT and X-ray. If the fracture is unstable, surgery is required. In younger patients, surgery will involve one of several techniques for spinal fusion and stabilization. In older patients, the burst fracture may be stabilized with vertebroplasty, a procedure to stabilize the fractured vertebra with acrylic bone cement, or with cadaver bone tissue.

Treatment without surgery generally involves a full-body, exterior brace, such as a Thoracic Lumbar Sacral Orthosis (TLSO), typically custom-molded to fit the patient’s body, which is worn 24/7 for two or three months. Physical therapy follows this to rebuild muscles and often to learn to walk again.

Extreme pain typically accompanies the burst fracture injury and its treatment. Pain management treatment may extend for a long time, involving its own potential complications. Over the patient’s lifetime, pain, loss of function, diminished appearance and severe neurological deficits may develop.