Vertebral
Fractures
Fractures of the spinal vertebrae — from trauma, osteoporosis, or structural fragility — requiring careful assessment before treatment.
Vertebral Fractures
Fractures of the spinal vertebrae requiring careful assessment of stability and neurological risk before treatment decisions are made.
Not all vertebral fractures are emergencies. Stable fractures in the absence of neurological compromise are often managed conservatively. Unstable fractures or those with cord involvement require urgent surgical assessment.
Overview
Vertebral fractures occur most commonly in three contexts: high-energy trauma (road accidents, falls from height), osteoporotic compression fractures (in older adults, particularly postmenopausal women), and pathological fractures (where the bone has been weakened by a tumour or other disease process). Each requires a different approach to assessment and management.
What Causes It?
Trauma is the most common cause in younger patients — road accidents and falls. In older adults, osteoporosis is the dominant factor — vertebral compression fractures can occur with minimal or no trauma, sometimes from a simple sneeze or bending forward. Awareness of osteoporosis is critical: it is frequently undiagnosed until a fracture occurs.
What Does It Feel Like?
Sudden onset of severe, localised back pain at the fracture level — often after a specific incident, though in osteoporotic fractures the triggering event may be trivial. Neurological symptoms — weakness, numbness, loss of bladder or bowel function — indicate the spinal cord or nerve roots are involved and require urgent assessment.
How Is It Diagnosed?
CT scanning provides the most detailed assessment of fracture pattern and bony stability. MRI is essential when neurological involvement is suspected. In osteoporotic fractures, MRI also determines whether the fracture is acute or chronic — an important distinction for treatment decisions. A DEXA scan assesses bone density in patients with osteoporotic fractures.
Non-Surgical Treatment
Stable fractures without neurological compromise are managed with pain relief, rest, and gradual mobilisation. A brace may be used to reduce movement at the fracture site and improve comfort. Osteoporotic fractures additionally require treatment of the underlying bone density — bisphosphonates, calcium, and vitamin D. Bone health management is essential to prevent further fractures.
When Is Surgery Considered?
Surgery is considered for unstable fractures at risk of further collapse or cord injury, for fractures with existing neurological compromise, for fractures that fail to heal with conservative care, and for osteoporotic compression fractures causing significant persistent pain. Vertebroplasty and kyphoplasty are minimally invasive options for appropriate osteoporotic fractures.
Recovery
Recovery depends on the type of fracture and treatment. Conservative management may take several weeks to months for pain to resolve and mobility to return. Following vertebroplasty or kyphoplasty, many patients experience rapid pain relief and are mobile within 24 hours. After spinal fusion, recovery is gradual, with return to daily activities over several months and full healing up to a year.
Ready to understand
your options?
A consultation will give you a clear diagnosis and a plan — conservative or surgical, whatever applies to your situation.