FRACTURE of the THORACIC and LUMBAR SPINE (Mid and Lower Back)
The most common spine fractures are of the mid back and lower back or at the junction of the two. These fractures are typically caused by high velocity accidents such as a car crash or fall from height.
Men experience fractures of the thoracic or lumbar spine four times more often than women. Seniors are also at risk for these fractures, due to weakened bone from osteoporosis. Because of the energy required to cause these spinal fractures, patients often have additional injuries that require treatment. The spinal cord may be injured, depending on the severity of the spinal fracture (AAOS, 2013).
Common cause of fractures to the thoracic spine, lumbar spine, and thoracolumbar junction include:
- Falling from a height with great speed or force.
- Car crashes and impacts exceeding speeds as low as 35 mph.
- Gun shot wound.
- Blunt trauma.
Any injury to the vertebrae can have serious consequences to the spinal cord, the central nervous system’s connection between the brain and the body, runs through the center of the vertebrae. Damage to the spinal cord can result in paralysis or death. Injury to the spinal cord at the level of the thoracic and lumbar spine can lead to temporary or permanent paralysis of the entire body below the point of injury.
At first evaluation, it may be difficult to assess the extent of injuries to patients with fractures of the thoracic and lumbar spine.
At the accident scene, first check vital signs, including the patient’s consciousness, ability to breathe, and heart rate. After these are stabilized, workers will assess obvious bleeding and limb-deforming injuries.
Before moving the patient, you must immobilize the patient in a cervical (neck) collar and backboard. The trauma team will perform a complete and thorough evaluation in the hospital emergency room.
The treatment plan for a fracture of the thoracic or lumbar spine will depend on:
- Other injuries and their treatment
- The particular fracture pattern (i.e. Flexion, Extension, Rotation)
Once the trauma team has stabilized all other life-threatening injuries, the doctor will evaluate the spinal fracture pattern and decide whether spine surgery is needed. Each type of fracture has a surgical and nonsurgical option for treatment depending on severity and progress. Surgery is necessary if the fracture is unstable, fragmented, and if there is nerve or ligament damage.
Improvements in athletic equipment and rule changes have reduced the number of sports-related spinal fractures over the past 20 years. You can help protect yourself and your family if you:
- Always wear a seat belt when you are driving or a passenger in a car.
- Get checked regularly for osteoporotic risks.
- Wear the proper protective equipment for your sport and follow all safety regulations, such as having a spotter and appropriate cushioning mats.