Fractured Spine (Vertebrae)

What is a fractured spine?

A fractured spine is a medical term for breaking any of your vertebrae, the 33 bones that make up your spinal column. A single bone in your spine is a vertebra — vertebrae is the plural form.

People sometimes refer to a spinal fracture as a broken back. Fractured vertebrae are usually caused by osteoporosis and traumas like falls, sports injuries or car accidents.

Most spinal fractures won’t need surgery, but you might need to wear a brace for a few months. However, severe spinal fractures will need to be surgically repaired.

Types of spinal fractures

A healthcare provider will classify the fracture in your spine based on where it is in your back and how your vertebrae are broken. They’ll also classify the fracture as stable or unstable, depending on whether your vertebrae are out of their usual alignment.

Segments of the spine

Your spine is divided into three main sections, all of which can experience a spinal fracture:

• Cervical spine fracture: Broken vertebrae in your neck.
• Thoracic spine fracture: Broken vertebrae in your upper back that runs from the bottom of your neck to the bottom of your ribs.
• Lumbar spine fracture: Broken vertebrae in your lower back.

Fracture types

The most common types of spinal fractures include:

• Compression fractures: Compression fractures are small breaks or cracks in your vertebrae that are caused by traumas or develop over time as a result of osteoporosis. Osteoporosis is a disease that weakens your bones, making them more susceptible to sudden and unexpected fractures. An undiagnosed spinal compression caused by osteoporosis can make you lose several inches from your height or develop a hunched forward posture (kyphosis).
• Burst fractures: Burst fractures happen when your spine is suddenly compressed with a strong force. They can cause your vertebrae to break into many pieces.
• Chance (flexion/distraction) factures: Chance fractures happen when your vertebrae are suddenly pulled away from each other. They’re almost like the opposite of a burst fracture.

Chance fractures vs burst fractures

Chance fractures and burst fractures are both types of spinal fractures. The difference is what causes them.

A strong force that suddenly presses your spine together causes burst fractures. This extreme compression on your vertebrae can break them in many places at the same time. Falling from a great height and landing upright on your feet is a common cause of burst fractures.

Chance fractures are caused by a strong force pulling your vertebrae away from each other. Instead of your spine getting compressed, Chance fractures happen when something pulls it apart. Many people with Chance fractures get them during car accidents after their seatbelt catches their lower body and their upper body is jerked forward. Always wear your seatbelt with the shoulder harness around the upper half of your body.

Stable vs unstable spine fractures

A stable versus an unstable fracture is another way a provider will classify your spinal fracture.

If you have a stable fracture, the injury that broke your vertebrae didn’t push or pull them out of their usual place in your spine. You still need treatment, but you’re less likely to need surgery.

Unstable spinal fractures happen when the injury moved your vertebrae out of their usual alignment. They’re more serious injuries than stable fractures. There’s a much higher chance you’ll need surgery to repair your broken vertebrae, and you’ll have a higher risk for dangerous complications that can affect your spinal cord.

Who gets spinal fractures?

Spinal fractures — like any bone fracture — can affect anyone. This is especially true for fractures caused by traumas like falls and car accidents.

Women, people assigned female at birth and adults older than 50 are more likely to experience spinal fractures.

You’re much more likely to experience a spinal fracture (especially a compression fracture) if you have osteoporosis. Once you’ve had a compression fracture, you’re five times more likely to develop another compared to someone who’s never experienced one.

In addition to osteoporosis, people with some health conditions or who take certain medications are more likely to experience a spinal fracture, including:

• Cancer (especially if you’re receiving chemotherapy or radiation therapy).
• People who use corticosteroids for a long time.
• Hyperthyroidism.
• Bone infections (osteomyelitis).
• Kidney disease.
• Anorexia nervosa.
• Vitamin D deficiency.

You’re also more likely to experience a spinal fracture if you:

• Smoke.
• Drink too much alcohol.

How common are spinal fractures?

In the U.S. each year:

• Osteoporosis causes more than 1.5 million compression fractures.
• More than 150,000 spinal fractures are caused by traumas.

How does a spinal fracture affect my body?

A spinal fracture might make it painful, difficult or impossible to move the way you usually can.

You’ll probably need to wear a brace that holds your back in place while the fracture heals (especially if you need surgery). While you’re wearing the brace it’ll be hard to move as freely as you’re used to. It might be uncomfortable, but it’s important to give your vertebrae the time they need to heal.

Severe fractures — especially unstable fractures — can damage your spinal cord and affect your ability to stand or walk. This damage might be permanent and irreversible.

Can you walk with a broken back?

Depending on what caused your spinal fracture — and which type of fracture you have — you’ll still be able to walk with a broken back. It might be painful (or make your pain worse), but if your fracture wasn’t caused by sudden trauma, it’s likely you’ll still be able to move. You won’t be able to walk if the fracture damaged your spinal cord enough to make you paralyzed.

Even if you have minor symptoms, visit your provider if you’re experiencing back pain that’s getting worse or doesn’t go away in a few days — especially if it’s accompanied by swelling or affects your posture. Go to the emergency room if you’ve experienced trauma.

What are the symptoms of a spinal fracture?

Many people never notice they have a compression fracture. This is especially true if your broken vertebrae happen over time from osteoporosis and not after trauma. You might experience no pain and only find out you’ve had a compression fracture during imaging tests to identify or diagnose other conditions in the future.

Traumas usually cause burst fractures and Chance fractures. If you experience trauma like a fall or car accident, your broken back will be diagnosed as your injuries are treated. You might not notice specific symptoms from the fracture itself, especially if you’re treated in the emergency room.

If you do experience symptoms, they will include the following:

• Back pain: A sharp, intense pain in your back. Pain might also get increasingly worse over time, especially when you’re walking or moving.
• Swelling or tenderness: The area around the broken vertebrae may be swollen and painful to touch.
• Changes to your posture: A new slump or stoop in your spine that causes you to lean forward in ways you didn’t before.
• Tingling or numbness: A tingling or numb feeling in your back that might run down your arms or legs.
• Height loss: You might get noticeably shorter over time (sometimes up to 6 inches).
• Incontinence: A new loss of your ability to control your bladder or bowels.

What causes spinal fractures?

Fractured spine causes include:

• Osteoporosis: Osteoporosis makes your bones lose density and strength over time. This increased fragility increases your risk for many types of fractures.
• Trauma: Traumas put a lot of stress on your bones. Your spine is usually very flexible and moves with you. But, a sudden intense force like a car accident or a sports injury can exert more force than your spine can tolerate, which causes spinal fractures.
• Spinal tumors: Most spinal tumors result from cancer metastasis — cancer that has spread from another area of your body to your spine.

How are spinal fractures diagnosed?

Your healthcare provider will diagnose a spinal fracture with a physical exam and imaging tests. They’ll look at your back, feel for any spots that are tender or painful and identify any changes to the shape of your spine and posture. Make sure to tell them exactly where you’re hurting and when you noticed any new pain or discomfort.

If you experience trauma, the fracture might be diagnosed by providers in the emergency room. They’ll diagnose your fracture and any other injuries after you’re stabilized.

What tests are done to diagnose a compression fracture?

After a physical exam, you’ll likely need at least one of a few imaging tests to take pictures of your spine:

• X-rays: A spine X-ray will confirm a fractured spine, and show how out of place your bones are.
• Magnetic Resonance Imaging (MRI): Your provider might use an MRI to get a complete picture of your back and any damage inside it. This will show them tissue around your spine as well as your vertebrae. This is especially important to determine if your spinal cord is at risk of being damaged by your fracture.
• CT scan: If you need surgery, your provider or surgeon needs to know exactly how damaged your bones are. A CT scan will give them a more detailed picture of your bones and the surrounding tissue than an X-ray.

You’ll probably also need a bone density test (sometimes called a DEXA or DXA scan). This will show if you have osteoporosis, and how much it has weakened your bones.

How are spinal fractures treated?

How your fractured spine is treated depends on a few factors, including:

• What caused the fracture
• Which type of fracture it is.
• Where in your back the broken vertebrae are.

Most spinal fractures don’t require surgery. The most common treatments include:

• Bracing: You might need to wear a back brace to hold your spine in alignment and help your broken vertebrae heal properly. Most people need to wear a brace for a few months. Your provider will talk to you about which type of brace you’ll need and how long you’ll need to wear it.
• Physical therapy: Strengthening the muscles in your back can improve your overall strength, help reduce bone loss and reduce the risk of future spinal fractures. You might need to work with a physical therapist in person or do at-home exercises.
• Treating osteoporosis: If you have osteoporosis, your provider might prescribe medicine or over-the-counter (OTC) supplements to help strengthen your bones to prevent future fractures.

If you experience trauma, providers in the emergency room will treat your injuries in the order of severity, especially if some of them are life-threatening.

Spinal fracture surgery

If the spinal fracture is in danger of damaging your spinal cord, or if your pain doesn’t improve a few months after non-surgical treatments, you might need surgery. The most common surgeries to repair fractures are vertebroplasty and kyphoplasty.

• Vertebroplasty: Your surgeon injects liquid cement into your fractured vertebrae to strengthen it.
• Kyphoplasty: Kyphoplasty is similar to vertebroplasty, but before your surgeon injects the liquid cement into your vertebrae, they insert a tiny balloon into them. When they inflate the balloon, it pushes your bones back into their correct place and re-creates the space that was originally there before your fracture.

These are both usually outpatient procedures, so you should be able to go home the same day. You’ll need to rest in bed for up to 24 hours before returning to your normal routine. Avoid heavy lifting or intense exercise for up to six weeks after your surgery.

Your provider or surgeon will explain which surgery you need and why. If your spinal fracture was caused by a tumor — either cancerous or benign — you might need different or additional procedures to remove the mass before your spine can be repaired.

What medications are used to treat spinal fractures?

Usually, over-the-counter NSAIDs are all you’ll need to reduce the symptoms of a spinal fracture. Talk to your provider or surgeon before taking NSAIDs for more than 10 days in a row.

Osteoporosis medications

Your provider might prescribe medications to strengthen your bones if osteoporosis caused your spinal fracture, including:

• Calcitonin salmon: Calcitonin salmon is a synthetic hormone you take as a nasal spray. It can reduce pain and your risk of future spinal fractures.
• Calcium supplements: You might need to start a calcium supplement to support your overall bone health and reduce your risk for more fractures in the future.

Your provider may refer you to a bone specialist for additional treatments and to monitor your bone health in the future.

Complications/side effects of the treatment

Side effects of NSAIDs include:

• Bleeding.
• Ulcers.
• Stomach pain.
• Bowel complications.

Calcitonin salmon can have serious side effects, including:

• Nosebleeds.
• Sinus pain.
• Difficulty breathing.
• Difficulty swallowing.
• Swelling in the tongue or throat.

Spinal fracture surgery complications include:

• Failure to repair the fracture fully.
• Spinal cord damage.
• Bleeding.
• Infection at the injection site.
• Increased stress on vertebrae around the repaired bones.
• Developing a humpback (kyphosis).

How soon after treatment will I feel better?

Most people feel better a few weeks after starting treatment.

How long it takes your vertebrae to heal depends on which type of fracture you have, which of your vertebrae were broken and any other injuries you experienced.

How can I reduce my risk of spinal fractures?

Follow these general safety tips to reduce your risk of an injury:

• Always wear your seatbelt — including the shoulder harness around the upper half of your body.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that will help you maintain good bone health.
• Talk to your provider about a bone density test if you’re older than 50 or if you have a family history of osteoporosis.
• Use your cane or walker if you have difficulty walking or have an increased risk for falls.

You can prevent osteoporosis by eating a healthy diet and getting regular exercise. A diet rich in calcium and vitamins C and D encourages bone growth and strength. Exercises that make your muscles work against gravity like walking, jogging, aerobics and lifting weights strengthen your bones.

What can I expect if I have a fractured spine?

If the spinal fracture didn’t damage your spinal cord, nerves or other tissue around your spine, you shouldn’t have any long-term effects after a spinal fracture. If you were diagnosed with osteoporosis after your fracture, you’ll need regular bone density screenings to monitor how it’s affecting your bones.

If the fracture or other injuries damaged your spinal cord, your ability to move or walk might be permanently affected. These kinds of complications are more common after traumatic injuries, like unstable burst fractures or Chance fractures.

How long does it take a fractured spine to heal?

Most spinal fractures heal in around three months if you don’t need surgery.

People who need surgery will need longer to recover. It might take as long as six weeks to recover from the surgery, then an additional few months for your spine to heal. Your surgeon or provider will give you a customized recovery timeline after your procedure.

When can I go back to work/school

If you’re receiving non-surgical treatment for a fractured spine, you might not need to miss any time away from work or school if your job or coursework doesn’t involve heavy lifting.

You should be able to return to work or school within a week after spinal fracture surgery, but talk to your surgeon or provider before resuming any intense physical activities.

How do I take care of myself?

Talk to your provider about a diet and exercise plan that will help you maintain good bone health.

1 in 4 women and people assigned female at birth with a compression fracture caused by osteoporosis never get it diagnosed, even if they’re experiencing mild symptoms. Talk to your provider if you’re having any new pain or discomfort in your back. They can help you figure out what’s causing it, and potentially catch osteoporosis or other health conditions before they cause severe symptoms or fractures.

When should I see my healthcare provider?

Get any new symptoms or changes in your back examined by a healthcare provider as soon as possible including:

• Pain.
• Swelling.
• Discoloration.
• Tenderness.
• A noticeable change to your height or posture.

Go to the emergency room right away if you’ve experienced trauma.

What questions should I ask my doctor?

• Which type of spinal fracture do I have?
• Where in my back are the broken vertebrae?
• Do I have osteoporosis?
• How long will I need to wear a brace?
• Will I need surgery?
• How long will it take to recover?

A note from Cleveland Clinic

Experiencing a spinal fracture can be scary, especially because it’s usually caused by a sudden accident or over time without you even knowing it. Either way, you don’t know it’s happening until it causes you pain or other symptoms.

The most important thing you can do to avoid the long-term effects of a broken back is to see your healthcare provider right away if you notice any new symptoms.

Talk to your provider about your osteoporosis risk, especially if you’re older than 50 or have a family history.