Vertebral body fracture – an underestimated widespread disease

Vertebral body fracture – an underestimated widespread disease

A vertebral fracture or vertebral fracture most often involves a vertebral body fracture. Still, a vertebra’s vertebral arch, transverse, or spinous process can also be affected. A vertebral body can break under strong force and with small movements without external force. This affects the stability of the spine. Every year, almost 230,000 people between the ages of 50 and 79 suffer a vertebral fracture in Germany. Women and men are affected in a ratio of 10:6.

Vertebral fracture: possible symptoms

Sudden back pain can be an indication of a vertebral fracture, as can:

  • a more or less severe back pain
  • movement pain
  • misalignments
  • bruises
  • Prellmarken

If a vertebra of the cervical spine (cervical spine) is broken, head movements are only possible with pain, or the head even remains in a forced position.

If the spinal cord is also injured, the following symptoms may occur:

  • urinary and faecal incontinence
  • paralysis
  • sensory disturbances such as numbness
  • in extreme cases, paraplegia

The vertebral fracture sometimes goes unnoticed if the bone structure is already damaged due to an underlying diseaseOnly the constant, excruciating back pain led to his discovery.

 

Causes of a vertebral fracture

Healthy vertebral bodies can fracture under solid force, such as in a car accident with high impact speeds. All kinds of falls, for example, during sports such as horseback riding, skiing or paragliding, also harbour a fracture risk.

However, vertebrae sometimes break even without external force being applied during slight everyday stress and sometimes even without those affected immediately noticing it. This is the case, for example, with:

  • Osteoporosis, the most common consequence of which is a vertebral fracture (this is referred to as a sintering fracture)
  • bone tumours
  • The skeletal metastasis
  • Bone inflammation ( osteitis )
  • Bone softening (osteomalacia)
  • rheumatic diseases

In the case of a vertebral fracture caused by osteoporosis, the cover plate, i.e. the upper surface of the vertebral body, can be crushed. One then speaks of a cover plate impression or a cover plate collapse.

This is how the diagnosis is made.

The earlier a vertebral fracture is treated, the greater the chance of preventing irreparable consequences. After the consultation with the doctor and a subsequent physical examination with a check of the nerve functions, the injured spinal area is X-rayed in maximum flexion and extension.

Another computed tomography (CT) scan shows whether the fractured vertebral body narrows the spinal canal. If necessary, a second imaging procedure, magnetic resonance imaging (MRT), is used. This makes intervertebral discs, ligaments and the spinal cord visible.

 

Therapy for vertebral fractures

The first step is to relieve pain with suitable preparations, such as painkillers. Other conservative measures are:

  • Physiotherapy to restore mobility
  • relaxed bed rest
  • Under certain circumstances, a back corset or support bodice (or thesis) is to be worn every day, especially in the case of vertebral fractures in the lumbar spine (LWS)

Suppose it is a so-called stable vertebral fracture,  which occurs in about 85 per cent of cases; ligaments and soft tissue are unaffected, and the collapsed vertebra does not narrow the spinal cord canal. In that case, healing can then take place without surgery. In the case of so-called unstable vertebral fractures, fragments of the vertebral body are often displaced against the spinal canal, or the vertebral arch is even severed. Surgical measures are then usually required.

treatment by surgery

A vertebral fracture can be treated surgically in various ways: In balloon kyphoplasty, two cannulas are inserted into the vertebra, and two balloons are pushed through them into the vertebra. The balloons are carefully inflated so that the vortex slowly rises. The resulting cavity is filled with bone cement.

In vertebroplasty, a large hollow needle is inserted into the affected vertebra and bone cement is injected directly into the vertebral body without prior straightening. Any misalignment is retained.

During osteosynthesis, the broken bone is surgically stabilized with screws or a plate. In spinal fusion, two or more vertebrae are fused by attaching plates to the spine from the front and back.

If an underlying disease such as osteoporosis has led to the vertebral fracture, it must also be treated.

Prevent a vertebral fracture.

The only way to protect yourself against external violence, for example, on the road, is by using seat belts, airbags or a back protector when doing sports. If there is an increased risk of osteoporosis, a bone density measurement should be carried out. Physical activity such as muscle training, for example, dumbbells, cycling, swimming and spinal exercises are essential for the calcium build-up in the bones.

Furthermore, a balanced diet rich in calcium (1 to 1.3 grams daily), mineral water containing calcium, and the intake of vitamin D (1,000 units daily) prevent increased bone loss. If osteoporosis already exists, further bone loss can be inhibited with medication.

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