Cervical Spine Fractures

Learn about the different kinds of fractures of the spine and the different options for treatment.

Spinal fractures are breaks in any of the bones of the spinal column. They typically occur as a result of trauma, but can be a result of softening of the bones (such as in osteoporosis).

Although fractures are more common in the mid and lower spine (thoracic and lumbar spine), they can certainly occur in the bones of the neck (cervical spine) as well. When associated with instability or compression of nerves, fractures can often lead to symptoms including pain, weakness, numbness and tingling.

What causes a fracture?

Fractures occur when excessive loads are applied to the bones causing them to fail. Since normal bones usually do not fail under typical loads, the most common reason normal bones break is from traumatic injury. Common causes of traumatic injury to the spine include falls and car accidents.

Signs and symptoms

In addition to pain, pressure on nerves from fractures can also cause numbness, tingling, burning, and weakness in your arm. Severe narrowing of the central spinal canal from the fractured fragments can compress your spinal cord leading to balance difficulties, problems using your hands, and even paralysis of your arms and legs. If you experience bowel or bladder problems and have progressively worsening weakness in your arms or legs, you should seek medical attention immediately.

Diagnosis

The diagnosis is first suspected after a thorough history and physical examination are taken. The injured patient may complain of pain radiating from their neck down to their arms, especially with any attempt to bend or twist their neck.

Patients may also commonly complain of numbness, tingling, and burning down their arm. They may also have muscle weakness. If the narrowing from the fracture involves the spinal cord, symptoms can radiate to the legs as well. After a detailed examination, the diagnosis can be initially evaluated with plain X-rays and confirmed with an MRI or CT of the cervical spine.

Treatment

Most patients with stable traumatic cervical injuries can initially be treated conservatively with bracing, halo pin treatment, and/or pain management.

Patients with more severe and unstable injuries usually require surgical intervention. The procedure of choice may involve going through the front of the neck to take the pressure off of the neural elements and stabilize the spine (anterior cervical decompression and fusion, or ACDF).

Depending on the injured areas, a posterior approach from behind may be the preferred method to address your spinal injury. Your surgeon can go over the advantages and disadvantages of each of these surgical options with you.

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