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Spine Trauma and Fractures

A spinal fracture occurs when any of the vertebrae within the spinal column collapse and are compressed. A fracture is typically the result of high-impact trauma such as a car accident, but it also can be caused by conditions that weaken the bones, such as osteoporosis and cancer.

Most commonly, spinal fractures occur in the thoracic or lumbar spine or at the thoracolumbar junction where the thoracic and lumbar regions connect. Men are four times more likely than women to experience a spinal fracture.

Types of Spinal Fractures

There are three types of spinal fractures that are categorized by the pattern of the fracture:


Within the flexion pattern, a fracture is either considered a compression or axial burst. In a compression fracture, the vertebrae break. In an axial burst fracture, parts of the vertebrae shatter, typically making this type of fracture more severe.


When the vertebrae is pulled apart, this is known as a flexion/distraction fracture in an extension pattern. This type of fracture is also called a “seat belt injury” because it most often occurs in head-on car accidents when the lower body stays in place by the lap seat belt, but the upper body is thrust forward.


Within the rotation pattern, a fracture may be defined as transverse process or fracture-dislocation. A transverse process fracture is caused by extreme rotation or bending, while a fracture-dislocation is caused by vertebra separating from an adjacent vertebra, severely compressing the spinal cord.

Signs and Symptoms

The main and immediately obvious sign of a spinal fracture is moderate to severe back pain that becomes worse with movement. If the spinal cord is also injured, symptoms such as numbness, tingling, muscle weakness, and loss of bowel/bladder control may occur.

If you experience spinal trauma that may have resulted in a fracture, you should seek immediate medical care.


Treatment options for a spinal fracture are determined by the severity of the injury as well as the fracture pattern. The experts at Kelsey-Seybold Spine Center in Houston will explore all nonsurgical options first.

For a flexion pattern fracture, treatment may include wearing a brace for up to 12 weeks and physical therapy. For an extension pattern fracture, treatment may involve a brace or cast for up to 12 weeks if the fracture doesn’t involve the spinal discs. For a rotational pattern fracture, a back brace may be used while motion is gradually increased through physical therapy.

In some cases, surgery may be needed to treat a fracture that is too unstable to be supported by a brace or cast, is causing damage to the spinal cord or nerves, or has extended through the spinal discs. A surgical procedure would fit the vertebrae together again and remove any bone fragments compressing the spinal cord or nerves.

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