Vertebral fracture: information & vertebral fracture specialists

Leading Medicine Guide Editors
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Leading Medicine Guide Editors

A vertebral fracture is a break in a vertebral body in the spine. It does not necessarily cause symptoms, but in the worst case it can also affect the spinal cord. Here you will find further information as well as selected vertebral fracture specialists and centers.

ICD codes for this diseases: S12, S22.0, S32

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Brief overview:

  • What is a vertebral fracture? This refers to the fracture of a vertebral body in the spine. As a result, the spinal canal may be impaired and a spinal cord syndrome may develop.
  • Causes: Vertebral fractures usually occur as a result of a traffic accident, a fall or physical violence. However, bones break more easily with increasing age as they lose strength.
  • Symptoms: There are usually no symptoms. The patient's motor function and sensitivity may only be impaired if the surrounding tissue is impaired, for example due to pinching. Pain may also occur.
  • Diagnosis: After taking a medical history and performing a physical examination, the doctor uses CT to assess the type of fracture. A measurement of the nerve conduction velocity shows whether the spinal cord is impaired.
  • Treatment: The treatment options vary depending on the shape and severity of the hernia. Wearing a support corset may be sufficient in some cases. However, surgery(kyphoplasty, vertebestoplasty, spondylodesis) is often necessary.

Article overview

Overall, a vertebral body is an extremely stable bone fragment. Nevertheless, it can break in serious accidents.

In many cases, the spinal canal, in which the spinal cord is embedded, is also affected. The vertebral fracture can cause the spine to shift or bone splinters can affect the spinal canal. In this case, the affected person may even develop a paraplegic syndrome.

In Germany, around 230,000 people aged between 50 and 79 are affected by vertebral fractures every year. About two percent of all fractures are vertebral fractures.

What symptoms are associated with vertebral fractures?

In many cases, patients do not realize they have a vertebral fracture as there are no symptoms. The vertebral fracture is therefore often only noticed when the surrounding tissue is also affected. If the spinal cord is trapped, the affected patient's motor function or sensitivity can be significantly impaired.

The different types of vertebral fracture

In medicine, a vertebral fracture is differentiated between an

  • an impaction fracture,
  • a cleft fracture and
  • a burst fracture

a burst fracture. The latter can also occur in different directions and during a rotation.

If the vertebral fracture is caused by rotation, the transverse and spinous processes may break off. Damage to the rib attachments is also possible.

Formen von Kompressionsbrüchen an der Wirbelsäule
Illustration of compression fractures of the spine © Artemida-psy | AdobeStock

What causes a vertebral fracture?

In most cases, a vertebral fracture occurs as a result of a direct, violent intervention or compression. The cause is often

  • a traffic accident,
  • a fall from a great height or
  • physical violence.

This can cause the healthy bone to burst.

Accidents are by far the most common cause of vertebral fractures. The risk of vertebral fractures increases with age, as the bones wear out over time. A small amount of force is then sufficient to cause a fracture.

Osteoporosis can also increase the risk of a vertebral fracture. Osteoporosis reduces bone density, making the bone unstable and porous.

How is a vertebral fracture diagnosed?

As a rule, those affected go to the doctor when they feel pain. A vertebral fracture can then be diagnosed and surgery can be initiated.

The orthopaedic specialist will first take a medical history. He asks the patient about the symptoms. Only then will a physical examination and further measures be taken. The doctor has already gained an indication of what these should be from the medical history.

They can measure the nerve conduction velocity in order to assess the extent to which the spinal cord is affected.

As soon as the suspicion is confirmed, a suspected diagnosis is made and a referral is made to a specialist radiologist.

Using imaging techniques, such as a computer tomography scan, the doctor can determine what type of fracture is involved. Only once this has been clarified will he decide together with the patient how the vertebral fracture should be treated.

How is a vertebral fracture treated?

The type of treatment for a vertebral fracture depends on

  • how serious the fracture is in the individual case, and
  • the cause of the fracture.

For example, a multidirectional burst fracture, in which several vertebrae are affected, must be treated differently to a fracture of a single vertebra that is affected by osteoporosis. The aim of treatment is to ensure that the bone fragments grow back together safely.

Under certain circumstances, conservative therapy is possible, meaning that surgery is not necessary. The prerequisite is a stable fracture in which the vertebra has retained its shape. In addition, the surrounding tissue must not be affected.

Conservative measures include

  • the administration of painkillers,
  • wearing a support corset,
  • massages and
  • physiotherapy.

If symptoms appear, the fracture of the vertebra usually has to be treated surgically as part of spinal surgery. There are also various options for this.

Vertebestoplasty and kyphoplasty

In this procedure, a hollow needle is inserted into the affected vertebra. Bone cement is then injected through the needle. This quickly bonds the individual bone fragments together after hardening. This allows the vertebral body to stabilize quickly.

While vertoplasty can be performed under local anesthesia, kyphoplasty is currently only performed under general anesthesia.

A small balloon is first inserted into the vertebral body, which is then inflated. This also allows the vertebral body to be straightened and stabilized with bone cement.

However, both treatment methods should only be carried out four to six weeks after the actual fracture.

Spondylodesis

In the case of a serious vertebral fracture that is associated with complications, spondylodesis is usually the only treatment available. The surgeon removes the individual fragments or entire vertebrae from the spine and replaces them with a cage.

Spondylodese mittels Cage
Stabilization of the spine with a cage, clearly visible here in the X-ray image © praisaeng | AdobeStock

The doctors then use screws and plates to connect the vertebrae above and below the fracture site.

This procedure is used to treat serious fractures. It also restores stability to the spine. This also prevents damage to internal structures such as the spinal cord.

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