Jason E. Smith MD

Spine Surgeon with Baton Rouge Orthopaedic Clinic 

Call Us:  225-924-2424

Treatment


If the injury is limited to a break of a transverse process with no other bone or organ injury, hospital or spine specialist care may not be necessary. Medication for pain control, muscle spasms, and limitations in activity are done first followed by physical therapy later.

Transverse process fractures are common and usually coincide with trauma, although they are considered a minor and stable lumbar spine fracture. There is strong association between transverse process fractures and other traumatic injuries. 

Pathology

Transverse process fractures occur in the lumbar spine and usually there are multiple sites.   There are sometimes more serious fractures to the spine associated with these fractures, but if it is just a transverse process fracture it is a cause of pain but no neurological deficits.


Radiographic features

CT is the modality of choice. Up to 60% of lumbar transverse process fractures identified on CT will be missed on plain radiographs.

Transverse Process Fractures

Vertebral Body Compression Fractures

What Is A Vertebral Compression Fracture?

These fractures occur when the normal vertebral body is “squashed”, or compressed in height. When the load on a vertebra exceeds its stability or inherent strength, the bone can collapse. Pain, limited mobility, height loss and spinal deformity are often the result.

In rare and severe cases, part of the vertebral body may protrude into the spinal canal and put pressure on the spinal cord and nerves. Organ function, including that of the bowel or bladder, also may be compromised.

Vertebral compression fractures can happen for a number of reasons: trauma from a fall or a car accident; bone thinning due to osteoporosis or even the spread of a tumor into the spine.

Prevention is the best practice to avoid these types of injuries.

What Causes Vertebral Compression Fractures?

Osteoporosis
There is no one single cause; however, the vast majority of vertebral compression fractures are the result of osteoporosis, a condition that causes bones to progressively become more thin and fragile. When bones are brittle, even everyday activities and minor traumas, such as lifting a laundry basket, missing a step, or even coughing or sneezing, can cause these fractures.  The resulting deformity of the bone becomes "wedge-shaped".

Tumors
Tumors growing in or near the spine are another cause of compression fractures. Doctors frequently monitor those diagnosed with certain types of cancer, including multiple myeloma or lymphoma, for spinal breakage. Tumors also may spread to the spine as a result of cancer in other organs and areas of the body, such as the breasts, lungs and intestines.

Trauma
People with strong, healthy bones also can sustain compression fractures from a hard fall or blow to the back or torso. Vertebrae can withstand a good deal of shock; however, if the force on the spine is too great, they can break.

What Are The Symptoms of Vertebral Compression Fracture?

The primary physical symptoms of vertebral fracture include one or more of the following:

Sudden onset of back pain
Increase in pain when standing or walking
Variable pain relief when lying down or once standing up and walking for a couple of minutes
Limited range of motion of the spine with forward flexion or extension
Weakness or numbness in the affected areas

These additional symptoms signal the possibility of multiple vertebral fractures:

Hunched back (“dowager’s hump”)
Bulging abdomen
Gastrointestinal problems - crowding of the internal organs can be a serious side effect of multiple compression fractures.
Shortness of breath - it’s possible for the torso to become so compressed that it’s difficult to breathe.

How Are Vertebral Compression Fractures Diagnosed?


Pain onset is most often sudden.  The pain is usually very pinpoint in the back and can be very intense.  It will sometimes radiate to other parts of the body such as the legs.  The intense pain normally will last for 6 weeks and then gradually get better.


An X-ray usually can determine the presence of a fracture.

An MRI will be able to tell us the age of the fracture and if there is nerve involvement.

A nuclear bone scan can also tell us the age of the fracture.

















How Are Vertebral Compression Fractures Treated?

Treatment of compression fractures includes measures to alleviate the pain, stabilize and repair the fracture, and diagnose the underlying cause of the breakage.

Non-Surgical Measures:

Muscle relaxers and Pain relievers
A reduction in activity or rest
A spinal brace to limit motion, usually soft bracing is sufficient

Surgical Options


Balloon Kyphoplasty is the minimally invasive procedure if the conservative measures fail to reduce pain.

How Can I Prevent Vertebral Compression Fractures?

Exercise - strength/resistance training and/or lifting weights regularly, can help build strong bones. Engaging in some form of cardiovascular exercise and strength training at least three times a week can help combat bone loss, and the earlier you start exercising and strength training the better. Strong muscles also help you to maintain balance and avoid falls and other accidents.

Eat Right – Eat a nutrient-rich, balanced diet, with sufficient intake of calcium, Vitamin D and phosphorus. Avoid smoking and excessive alcohol use; smoking contributes to bone density loss and too much alcohol inhibits bone formation. If possible, maintain a healthy weight because additional weight adds more strain on the bones.

Stay Hydrated – Drink between six and eight cups or water a day to keep the body well hydrated. Water helps reduce stiffness and contributes to overall spine health.  Learn how to maintain bone density for a healthy spine.

Practice Good Posture – Maintaining a “neutral spine” is the foundation of good posture. In a neutral spine, the natural curves of the spine (the concave, or lordotic, curves, and the convex, or kyphotic, curves) are in proper balance. The spine is neither rounded forward nor arched back too much.

Proper posture keeps your bones properly aligned and alleviates excess stress on your musculoskeletal systems, allowing your muscles, joints, and ligaments to work as intended