Thoracic and lumbar fractures
The thoracic spine is the middle spine and the lumbar spine is the low back. Fractures to this part of the spine are common with trauma e.g. high speed motor vehicle accident, falls, gunshot to the back etc. The spinal cord can also be damaged depending on the severity of the injury. In the elderly with osteoporosis or those with other underlying conditions that result in weakness of the bones thoracic and lumbar fractures can occur with minor trauma and normal activities of daily living.
• Moderate to severe back pain made worse by movement.
• In some cases when the spinal cord is also involved, numbness, tingling, weakness or bowel/bladder dysfunction.
Management and diagnosis
First aid management of a possible thoracic or lumbar fracture is very important. It is essential that the back be kept as still as possible until an x-ray is done. The doctors will take x-rays and other scans to determine the extent and type of damage. They will also perform a neurological exam to determine if any damage has occurred to the spinal cord. As this injury occurs often in very traumatic circumstances there will also be other injuries.
Treatment will depend on which vertebrae have been fractured and the type of fracture. Crush fractures for example that often occur in the elderly are quite stable and require little intervention. On the other hand more severe fractures may require traction, surgery and internal fixation, two to three months in a rigid brace, or a combination of these treatments.
Once the fracture is healed and stable then physiotherapy would be recommended by your doctor to restore pain free function of the back and normal mobility. Obviously if there has been permanent damage to the spinal cord then in most cases you will spend time in a hospital spinal unit for rehabilitation.