Spinal Cord Injuries and Compression Fractures

Every year, an estimated 12,000 spinal cord injuries occur in the United States. Most are caused by trauma to the vertebral column, affecting the spinal cord’s ability to send and receive messages from the brain to the body’s systems that control sensory, motor and autonomic function below the area of injury.

The severity of an injury depends on the part of the spinal cord that is affected. The higher the injury on the vertebral column, the greater the effect on movement, feeling and voluntary control.

When a spinal cord injury is suspected, immediate medical attention is required. Our experienced neurosurgeons provide 24-hour coverage for trauma and emergency surgery at Texas Health Harris Methodist Hospital Fort Worth, providing integrated care from initial assessment through follow-up and rehabilitation.

Diagnosing and Treating a Spinal Cord Injury

SCI is typically diagnosed when the patient demonstrates a loss of function below the level of injury, commonly caused by a contusion or bruise to the spinal cord, vertebral compression, or the compromise of blood flow to the injured part of the spinal cord. Treatment often begins when paramedics or other emergency medical services personnel carefully immobilize the entire spine at the scene of the accident.

Signs and symptoms include:

  • Extreme pain or pressure in the neck, head or back
  • Tingling or loss of sensation in the hand, fingers, feet or toes
  • Partial or complete loss of control over any part of the body
  • Difficulty with balance and walking
  • Abnormal pain or pressure in the thorax
  • Impaired breathing after injury
  • Unusual lumps on the head or spine

Immediate surgery may be needed if the spinal cord appears to be compressed by a herniated disc, blood clot or other lesion, usually in cases of incomplete SCI or progressive neurological deterioration.

Even if surgery cannot reverse spinal cord damage, surgery may be needed to stabilize the spine to prevent future pain or deformity. Our team will work with you to decide which procedure will provide the greatest benefit.

Trauma Caused by a Vertebral Compression Fracture

VCFs occur when the bony block or vertebral body in the spine collapses, which can lead to severe back pain, deformity, limited mobility and loss of height. Most vertebral compression fractures occur in the middle portion of the spine and are caused by severe trauma, such as a car accident, sports injury or a hard fall. People with osteoporosis or tumors are at increased risk.

Segmental Instability. When a fracture causes a vertebral body collapse of more than 50 percent, there is a risk of segmental instability, which can produce pain, impair daily activities and speed degeneration of the spine in the affected area.

Kyphosis. The front of the vertebrae collapse and “wedge,” causing a rounded thoracic spine or hunchback, and, in severe cases, debilitating pain and compression of the heart, lungs and intestines. Kyphosis is common in older women with osteoporosis and recurrent VCFs.

Neurological Complications. If a fracture causes part of the vertebral body to place pressure on the spinal cord, the nerves and spinal cord can be affected. Pieces of the broken vertebral body may push into the spinal canal, causing narrowing that can lead to immediate injury to the spinal nerves, future nerve irritation, and reduced blood and oxygen supply to the spinal cord, causing numbness and pain.

Treating a VCF

Recent advances in spinal procedures have reduced the need for invasive surgery in many cases of VCF.

The skilled neurosurgeons of North Texas Neurosurgical & Spine Center perform several minimally invasive surgical procedures to treat vertebral compression fractures, including:

  • Vertebroplasty. Depending on the number of vertebrae treated, this outpatient procedure typically takes one to two hours. Using a local anesthetic and intravenous sedation or general anesthesia, a small X-ray-guided needle injects acrylic bone cement into the collapsed vertebra. The cement hardens within minutes, strengthening and stabilizing the fractured vertebra.
  • Kyphoplasty. In this procedure, two small incisions are made and a probe is placed into the vertebral space by the fracture. The bone is drilled, and balloons are inserted on both sides and inflated with contrast medium until they expand to the desired height. The balloons are then removed, and the resulting spaces are filled with cement, stabilizing and restoring height to the spine.

Many patients report significant pain relief after these procedures, but there is no guarantee that surgery will help every individual. Our team will help you determine the best treatment plan for you.