Broken Back or Thoracic/Lumbar Spine Fracture: Causes, Symptoms, Treatment, Recovery, Complications

Broken Back or Thoracic/Lumbar Spine Fracture is a fracture occurring to any part of the back bone and thus causing injury to spinal cord. The severity of the broken back or thoracic/lumbar fracture can vary from a minor hairline fracture to severe life threatening fracture.⁽¹⁾ In most cases of the spinal fractures, the fracture is caused to the lumbar spine (lower back) or thoracic (midback) or the junction of the two. There can be various reasons for the broken back including a major accident or simple weakening of the bones.

Broken Back or Thoracic/Lumbar Spine Fractures are usually caused by a severe impact on the back that has enough energy to break some part of the back bone. Some of possible causes are as follows:

• A accident on a highway while driving a motorcycle or car can cause Broken Back or Thoracic/Lumbar Spine Fracture.
• A severe injury while playing an outdoor sport.
• An event involving a fall from top of a tall building or structure.
• An injury caused due to a serious violent act.

Broken Back or Thoracic/Lumbar Spine Fractures are usually associated with multiple injuries on different parts of the body. Most of the times, the impact of injury also causes damage to the spinal cord, making the condition of the patient more severe.

In less severe cases of Broken Back or Thoracic/Lumbar Spine Fractures, bone insufficiency or weakness of bones can lead to fractures on the back. There are several medical disorders or conditions that may lead to weak bones such as tumors, osteoporosis etc. If the bones are weak, simple twisting of back or a light impact can cause fractures. Hairline fractures can remain unnoticed unless the constant pressure on the bone results into a proper fracture.

Broken Back or Thoracic/Lumbar Spine Fractures comes with some clear signs and symptoms. The common symptoms are as follows:

• Back pain whose severity depends on the impact and injury to the lumbar or thoracic spine.
• In case of Broken Back or Thoracic/Lumbar Spine Fracture causing damaging to spinal cord, bowel/bladder may stop functioning properly.
• Another common symptom of Broken Back or Thoracic/Lumbar Spine Fracture is the feeling of weakness or numbness in the limbs.

In case of a severe impact on the back or a serious Broken Back or Thoracic/Lumbar Spine Fracture, the person usually loses consciousness because of the injury to spinal cord or brain. If a person experiences severe pain on the back which is severe than the normal back pain, there is always a chance of broken back, especially after an accident or something.

Broken Back or Thoracic/Lumbar Spine Fracture are usually caused due to a severe accident that would mostly require an emergency attention from the emergency team of doctors or experts attending the situation. A simple visualization of the injury does not give a clear indication of the extent of the injury. The patient must be rushed to the nearest medical facility for the proper medical examination including physical examinations as well as medical tests.

1. Physical Examination for Broken Back or Thoracic/Lumbar Spine Fracture

   The first thing that doctors wants to look for access in Broken Back or Thoracic/Lumbar Spine Fracture is the damage to vital organs of the body. Physical examination involves evaluation and inspection of different portions of the body starting from head to toe. It includes examination of spinal cord, chest, head, limbs and pelvis.

2. Medical Tests for Broken Back or Thoracic/Lumbar Spine Fracture

   Neurological tests are done to diagnose Broken Back or Thoracic/Lumbar Spine Fracture. In case of thoracic and lumbar spine fractures, there is always a risk of neurological issues. Thus, neurological tests are important part of evaluating the damage to spinal cord. The doctor during this test checks for the reflexes of the patient and his ability to identify the position of limbs. The main purpose of these tests is to access the possibility and severity of damage to spinal cord.

   Imaging tests are also conducted for diagnosing Broken Back or Thoracic/Lumbar Spine Fracture.⁽²⁾ There are various types of imaging techniques starting from simple X-rays to advanced magnetic resonance imaging (MRI) scans and computed tomography (CT) scans to look for the abnormalities in the structure of the internal organs of the body. In case of Thoracic and Lumbar Spine Fractures, CT scans and MRI scans are focused to the portion of the body around the back bone.

The treatment options for Broken Back or Thoracic/Lumbar Spine Fracture can be divided into two categories of no-surgical and surgical treatments.

1. Nonsurgical Treatment for Broken Back or Thoracic/Lumbar Spine Fracture

   There are three types of Broken Back or Thoracic/Lumbar Spine Fracture patterns including flexion fracture pattern, extension fracture pattern and radiation fracture pattern depending on the pattern of the damaged bones. Flexion Fracture Patterns usually involve osteoporotic compression fractures or stable burst fractures that can be treated with non-surgical treatment options. The most commonly used non-surgical treatment option is bracing which may be required for a period of 6-12 weeks.

   Extension fracture patterns in Broken Back or Thoracic/Lumbar Spine Fracture usually do not require surgical treatment options. The fracture in this case can be treated with the help of a cast or brace for a period of around 12 weeks.⁽³⁾

   In case of radiation fracture patterns in Broken Back or Thoracic/Lumbar Spine Fracture, bracing may or may not be required. A patient can recover from the fracture by gradually bringing the body into motion.

2. Surgical Treatment for Broken Back or Thoracic/Lumbar Spine Fracture

   Surgical treatment options for Broken Back or Thoracic/Lumbar Spine Fracture are adopted only when the non-surgical methods are not capable of rectifying the fracture or underlying problems. In case of flexion fracture pattern, unstable burst fractures with other complications such as severe injury to nerve, angulation or forward bending at the site of injury, multiple bone fragments etc may require surgical treatment options. Surgical treatments involves removal of bones that are threatening to damage spinal cord. This method is called as laminectomy.

   Surgical treatments options for extension fracture patterns in Broken Back or Thoracic/Lumbar Spine Fracture come into play when fracture can damage ligaments on the back of the spine. Surgery may also be required if fracture is located in the disk of the spine.

   Surgical treatment is only required if lumbar or thoracic spine is displaced significantly from its original location in case of radiation fracture patterns.

The objective of the first aid for Broken Back or Thoracic/Lumbar Spine Fracture is to keep the victim safe and immobile for the medical services to arrive.

• Call the emergency medical services immediately.
• Keep the victim’s neck and head in the same posture in which they were initially found.
• Never try to reposition the head/neck.
• Make sure that the neck is not bent or twisted.
• You should not remove the helmet of there is a broken back.

If the person with Broken Back or Thoracic/Lumbar Spine Fracture is not responding then:

• Check for breath, pulse and blood circulation.
• If there is no pulse try mouth breathing and cardiopulmonary resuscitation or CPR.
• In order to open the airway never tilt the head backwards, instead of that you can keep your fingers on both sides of the victims jaw and lift their jaw forward.

The recovery period or healing time for Broken Back or Thoracic/Lumbar Spine Fracture cannot be specified as it depends on lots of factors such as severity of the injury, delay in treatment, type of treatment options, cause of the injury etc… Thus, every individual needs to check with his or her doctor to find out the exact time that will be needed for complete recovery.

All types of medical conditions or deficiencies in body that may result in weaker bones with low bone density such as osteoporosis can all increase the risk of Broken Back or Thoracic/Lumbar Spine Fractures even in case of a light impact.

Broken Back or Thoracic/Lumbar Spine Fractures can become severe and even life threatening because of the associated complications. Some of the possible complications are as follows:

• Pneumonia is a complication of Broken Back or Thoracic/Lumbar Spine Fracture.
• If the person remain idle without physical movements such as bed rest, spine fractures can cause clotting of blood in legs and pelvis.
• Pulmonary embolism is complicated form of clotting of blood in which the blood leaks out to the lungs.
• Pressure sores.

If Broken Back or Thoracic/Lumbar Spine Fractures are associated with spinal surgeries, following complications may occur:

• Leakage of fluid present in Spinal cord.
• Infection.
• Nonunion.
• Failure of body organs.
• Bleeding.

Complications associated with Broken Back or Thoracic/Lumbar Spine Fracture can be avoided by seeking proper medical care immediately after an injury or when the fracture is suspected.

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