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Sebastian Lattuga MD; Spinal Fracture


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Sebastian Lattuga MD provides patient education materials on spinal fractures
A spinal fracture is referred to as a vertebral compression fracture because when a vertebra breaks, it typically collapses and becomes compressed.
It’s important to seek treatment if you suspect you might have a spinal fracture. Early treatment can help restore the deformed vertebra to its correct shape

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Sebastian Lattuga MD; Spinal Fracture

  1. 1. + Spinal Fracture New York Spinal Specialists© 2012 SpineSearch LLCDesign BRAVA Creative
  2. 2. + Spinal fracture  The spinal column is made up of 33 bony segments stacked on top of one another. These segments, called vertebrae, have an inner layer of soft bone and an outer layer of hard bone. The round portion of bone at the front of each vertebra is called the vertebral body.  The bones in your spine aren’t as dense as some of the other bones in your body. For example, the bones in your legs are designed to withstand rigorous movement and force. In contrast, the bones in your spine are smaller and more “flexible” in order to accommodate a variety of movements such as bending or twisting.  This difference in bone architecture is one reason the bones in your spine are more vulnerable to fracture.  A spinal fracture is referred to as a vertebral compression Spinal column segment fracture because when a vertebra breaks, it typically illustrating the vertebral bodies (left). collapses and becomes compressed.Patient Education
  3. 3. + Causes of spinal fracture  Advanced age  Osteoporosis  Low bone mineral density  Long term use of medication, e.g., corticosteroids  Certain types of cancer; tumors  Trauma, i.e., car accident, fall, gunshot Osteoporosis is one of the most  Low levels of estrogen or common causes of spinal fracture in testosterone adults.  Sedentary lifestyle  Degenerative spine conditionsPatient Education
  4. 4. + Men: Don’t underestimate your risk Osteoporosis is not a disease exclusive to women. Men can have it, also. In fact, over 2 million American men have osteoporosis and another 3 million men are at risk for developing the disease. Osteoporosis can occur on its own or be caused by medication/other diseases.Osteoporosis risk factors for men Age > 50 History of alcohol excess Osteoporosis is a silent disease. Many people don’t know they have it until a Low serum levels of Vitamin D fracture occurs. Prostate cancer with prolonged androgen deprivation therapy Smoking, chronic obstructive pulmonary diseasePatient Education
  5. 5. + More than just a broken bone In some ways, a spinal fracture can be more debilitating than a broken arm or leg. There is a hollow space in the the middle of each vertebra that houses and protects the spinal cord. Nerves branch off the spinal cord, passing between the vertebrae on their way out to the rest of the body. Bone fragments from a fractured vertebra may compress and damage adjacent nerves or the spinal cord. A spinal fracture also affects the alignment of the spine by shortening it and pushing it forward. Vertebrae in the thoracic (chest) and lumbar (lower back) regions have the greatest risk for fracture.
  6. 6. + Symptoms of a spinal fracture  Sudden, severe pain related to trauma or specific activity  Mild pain that develops slowly, over time is a common symptom. This type of pain is often mistakenly attributed to aging or a simple backache.  Pain from a spinal fracture may be diffuse (spread out) or confined to a specific area. As a general rule, pain will worsen with movement. Sometimes there is no pain at all.  Multiple spinal fractures can cause stooped posture or a protuberance of the upper back, i.e., a dowager’s hump. Picture your spine as a column of blocks stacked one on top of the  Height loss may occur with multiple fractures other. If one of the blocks changes because, with each fracture, the spine shortens shape or collapses, it affects the and tilts forward. entire column.
  7. 7. + Did you know? Spinal fractures are classified as either stable or unstable. A stable fracture doesn’t cause significant alterations in spinal anatomy. The spine is still able to withstand weight and the spinal nerves are intact. With an unstable fracture, vertebral deformity, nerve damage and spinal misalignment are common. Left untreated, a fractured vertebra will usually heal on its own. The problem with this is that the bone heals in the fractured Men are 4 times more likely to have a position. traumatic spinal fracture than women. It’s important to seek treatment if you suspect you might have a spinal fracture. Early treatment can help restore the deformed vertebra to its correct shape.
  8. 8. + Types of spinal fracture Compression fracture Sudden downward force causes the vertebral body to collapse. This type of fracture is common in people with osteoporosis or other conditions that cause bone loss. Wedge fracture Similar to a compression fracture except that only one part of the vertebral body Burst fracture collapses. The vertebra then becomes Generally caused by trauma (fall, car wedge-shaped. accident, etc). A burst fracture is a significant injury that crushes the entire vertebra. Bone fragments are displaced and spinal cord injury may occur. Almost half of all spinal fractures are caused by car accidents.Patient Education
  9. 9. + How are spinal fractures diagnosed? Spinal fractures can be overlooked during routine exams and often go undiagnosed. If you have back pain unrelated to specific injury, talk with your doctor about an X-ray. However, be aware that spinal fractures aren’t always visible on X-ray. If your X-rays are negative, but your back pain persists, Magnetic Resonance Imaging (MRI) is a reasonable next step. In certain cases, Computed Tomography (CT) may be ordered. Evaluation of both the clinical findings and CT is useful for viewing soft tissue imaging studies lead to accurate diagnosis. and changes in bony structures.Patient Education
  10. 10. + Nonsurgical treatment for spinal fracture Treatment goals for spinal fracture include:  Management of pain  Stabilization of the fracture Typical treatment regimen  Pain medication  Back brace – maintains spinal alignment; controls pain by limiting movement  Rest  Gradual return to normal activity over a period of 8 –12 weeks. Many patients with spinal fracture respond well to nonsurgical treatment.Patient Education
  11. 11. + Minimally invasive treatment Vertebroplasty and Kyphoplasty are two minimally invasive procedures for the treatment of spinal fracture. Both have been shown to significantly reduce or eliminate spinal fracture-induced back pain, sometimes immediately after the procedure. For patients with significant loss of vertebral height and/or instability, spinal fusion surgery will most likely be recommended. Many minimally invasive procedures offer the possibility of same day surgery and less down time.Patient Education
  12. 12. + Vertebroplasty vs. Kyphoplasty How they’re similar How they’re different Under fluoroscopic guidance, a During vertebroplasty, bone fragments biopsy needle is inserted through a are cemented together in the fractured small incision in the patients’ back. position. The physician injects bone cement With kyphoplasty, balloons are first into the fractured vertebra. inserted and inflated inside the fractured vertebra. The cement dries quickly, creating an internal cast that stabilizes the Inflating the balloons expands the fracture. compressed vertebra and restores its normal shape, in as much as possible. The balloons are removed and the cement is injected. Vertebroplasty and kyphoplasty can often be done on an outpatient basis with the patient under light sedation.Patient Education
  13. 13. + Surgical fusion for treatment of spinal fracture Spinal fractures that cause neurological problems require immediate intervention to stabilize and align the spine. The surgeon may recommend spinal fusion – a procedure that “fuses” two vertebrae together with hardware and/or bone graft. The goal of surgical fusion is to restore spinal stability and return the patient to an optimal level of function. After surgery, it takes several months for the fused vertebrae to form one solid segment of bone. Abnormal movement between two vertebrae can damage the spinal cord and nerves.
  14. 14. + Don’t ignore back pain Once you have a spinal fracture, your risk for another is significantly increased. Self-diagnosis or thinking, “It can’t happen to me” will not work to your advantage in the long run. Be smart. If you have back pain and/or risk factors for spinal fracture, make an appointment to see your doctor right away. Early detection and treatment are the keys to living well. Treat a spinal fracture the same way you would treat a broken arm. If it’s broken – fix it.Patient Education