Spinal Fractures - Medical Negligence Solicitors – Compensation Claims

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Spinal Fractures

Spinal fractures are caused by falls, sports injuries, violence, motor vehicle accidents, and gunshot or knife wounds. It can involve just a fracture, a dislocation, or a fracture/dislocation. Bone fragments can separate from the main body of the vertebra, leading to damage to the spinal cord. A dislocation of one vertebra upon another can also lead to spinal cord damage. The main symptoms of a spinal cord injury include severe pain in the back, problems walking, inability to move both your arms and legs, and other symptoms. A great many of the fractures will heal without surgery but severe fractures need surgery to put the bones in the right position again.

The spine is made up of 33 bones, each of which is called a vertebra. They provide support for much of the body and allow you to stand in an upright position, move forward, and twist the body. The vertebra consists of a cylindrical body and several spinous processes and facet joints. The spinal canal is next to the body and is enclosed by the body and the processes. The spinal canal contains the spinal cord, which contains all the nerves that supply the movement and sensation below the neck.

Spinal fractures can be located in the cervical, thoracic, or lumbar area and have different symptoms depending on the location. They can represent mild ligamentous injuries, such as is seen in whiplash. It can be as severe as a fracture dislocation, causing quadriplegia or paraplegia. The cord can be pinched, torn or compressed.

In a whiplash injury, the neck is hyperextended and hyperflexed, usually the result of an automobile accident. The jerking activity strains the muscles and sprains the ligaments. The discs can be bulging as a result of the injury. Symptoms include headaches, neck pain, and stiff muscles. There is no spinal fracture in a whiplash injury.

If there is a fracture/dislocation, there is often instability of the spine. It causes excessive motion of the vertebrae and there are torn ligaments and stretched tissue. A bone is almost always broken. This can cause pain and can damage the nerves of the spinal cord. These usually need surgery to put the bones in place and keep them aligned with pins and plates.

A total of five to ten percent of fractures occur in the cervical area. About 64 percent occur between T12-L1, in the thoracolumbar region. Other fractures can occur in the thoracolumbar area as well. There are three categories of spinal fractures:

  • Fractures alone. The most common one is called a vertebral compression fracture. It happens when there is a downward force on the spine that blows out the vertebral body in a type of fracture known as a “burst fracture”. Bony fragments can be sent into the spinal canal, damaging spinal nerves. Those with osteoporosis or tumors of the spine can cause weakened bones that are prone to compression fractures. This is why people with osteoporosis can develop multiple compression fractures and dorsal kyphosis—a dowager’s hump.
  • Dislocation alone. This happens when the ligaments or discs are torn or dislocated and the bones come out of natural alignment. This can happen in seatbelt injuries. The spinal cord can be compressed because the spine is no longer stable. There is usually a stabilization surgery required followed by use of a spinal brace.
  • Fracture/dislocation. These tend to be the most severe type of spinal fracture. The ligaments are torn and one or more bone is fractures. The spine is almost always unstable and often there is damage to the spinal cord. Surgery is usually necessary to align the bones and repair the tendons. There can be plates and screws to hold the bony pieces together.

The main symptoms of a spinal fracture include back pain or neck pain, numbness of an arm and leg or just the legs, muscle spasms in the neck or thorax, weakness, tingling, problems with bowel or bladder function and complete paralysis of the legs or the arms and legs together. Remember that not all spinal fractures lead to a spinal cord injury.

The causes of spinal fractures are car accidents in 45 percent, falls in 20 percent, sports injuries in 25 percent, and acts of violence in 15 percent. Five percent are miscellaneous. Osteoporosis or tumors of the spine contribute to many cases of spinal fractures. Eighty percent of cases are people aged 18-25 years and men are four times as likely to have a spinal fracture due to an increase in risky behavior.

X-rays can diagnose bony vertebral fractures in many cases. In some cases, it is necessary to do a CT scan to look at the bones in a three dimensional fashion. An MRI is perhaps the best test because it can show the spinal cord, the bones and the soft tissue around the spinal bones. It can be used with a contrast medium or without a contrast medium (dye).

The treatment of a vertebral fracture includes management of pain and stabilization of the spine so no further injury occurs. Bracing may be required to maintain alignment of the spine, immobilize the spine as it heals, and controls pain. Stable fractures are treated this way and generally, they do well. A brace may be necessary for 8-12 weeks so the spine heals properly.

In some cases, surgery is necessary to treat fractures that are unstable. A fracture may require fusion of two vertebrae with a bone graft to hold together the two vertebrae. Plates, rods, pedicle screws, and hooks are used to join the vertebrae above and below a damaged vertebra. It can take months for the fusion to be permanent.

There are two procedures called kyphoplasty and vertebroplasty. They are minimally invasive procedures used to treat vertebral compression fractures caused by spinal tumors or osteoporosis. In the vertebroplasty, bone cement is injected into the fractured vertebra. It seals the bone into a normal position. In a kyphoplasty, a balloon is inserted into the break and is allowed to expand the compressed vertebra. Then bone cement is filled into the space where the bone is compressed.

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