Sometimes people fall and hurt their back. That’s what happened to our patient, whom we’ll call Kathy (fake name).
Kathy is a 60-year old woman. She slipped at her home, fell and, from then on, she felt a sharp pain on her back.
She took painkillers for some days, but the pain wouldn’t go away, so she decided to go to the doctor. Then, they performed a CT, which showed a lumbar fracture. His L2 vertebra had a fracture.
Most of the time, an x-ray is enough to find the vertebral fracture. In this case, we have a lumbar CT instead. But that is fine, too, because it shows the fracture nicely. What we have here is a compression fracture.
Compression fractures happen because the bone is too weak to endure all the weight. With some fall or bad movement, the vertebral bone colapses and… voilà, you have a fracture.
This is actually ver common, especially after a certain age (let’s say 65 years), because bones lose their calcium and get weaker. This happens even more frequently in women after their menopause.
When your bones get weak in old people, we call that “osteoporosis“.
In Kathy’s case, there are 2 things working on her favor:
- there are no displaced fragments invading the canal
- she doesn’t have any trouble moving and feeling her legs
These 2 facts are crucial. Sometimes, these fractures can compress the spinal cord or the nerves and cause paralysis. In those cases, you may need surgery right away.
The worst example is a fracture at a higher level, at the neck. Those fractures can cause paralysis of arms and legs—in fact, you can’t control anything below your neck, we call it tetraplegia.
Fortunately, that’s not our case, as Kathy can move arms and legs alright. She can also control her pee and poo, which we must also check after this type of accident.
Because there was no neurological damage, doctors treated Kathy with some back bracing and rest.
After some weeks, the bone healed and the pain improved.
Once you get your first fracture, you are prone to new ones. If you look carefully at our image, you will see there was another fracture at L1 level, only this one is an old one.
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