In healthy patients, a spinal fracture is almost always the result of a significant trauma to the spine. Patients who have tumors of the spine or osteoporosis can develop pathological fractures, or fractures that result from a seemingly minor trauma.
There are many different types of spinal fractures, and many of the less severe types can be treated nonoperatively with a brace and narcotic analgesics or nonsteroidal anti-inflammatories. Fractures that are typically treated with an operation include
- Fractures with bone fragments that compress the spinal cord or nerve roots
- Fractures associated with neurological deficits such as weakness, difficulty walking, or bowel/bladder incontinence.
- Fractures that cause the spine to be mechanically unstable, or
- Fractures that cause pain that does not respond to conservative nonoperative measures.
A special kind of fracture, called a compression fracture, is typically associated with pain only, and can be treated with an outpatient procedure called kyphoplasty. All other operative lumbar fractures are usually managed with minimally invasive instrumentation with screws and rods, followed by a posterolateral lumbar fusion (PLF).