Prognosis of vertebral fracture

A vertebral fracture leads to a permanent change in the vertebral body and thus also in its function. In contrast to other bones, bone that has once been immersed cannot straighten up again. Whether problems develop from this is practically impossible to predict.

A resulting healing in malformation can permanently overload adjacent areas. If nerve injuries have occurred due to the fracture of a vertebra, the extent of the damage and the time until the damage could be repaired is decisive for the prognosis. Slight nerve irritations almost always recede, the prognosis is unfavorable in the case of a cross-sectional symptomatology, but a complete recovery is also conceivable here.

If an osteoporosis-related vertebral fracture is present, osteoporosis therapy is of decisive importance, since without therapy, further fractures of other vertebral bodies are threatened. The healing of a vertebral fracture depends largely on the extent of the injury. If several vertebral bodies are affected and at the same time the supporting ligaments of the spinal column are also injured, the fracture can be a complicated one, which can often lead to further complications.

If the fracture is treated surgically with screws and stiffening, the healing process takes six to eight weeks. By means of surgery, the fractured vertebral body is often connected from the front and back with rods to the adjacent vertebral bodies, thus initially stiffening and protecting them. Thus, the entire spinal column is initially secured and also stable under load.Nevertheless, the wounds and also the fractures have to heal until a full load is possible again.

In severe cases, when the vertebral body can no longer be rebuilt, it is replaced partially or completely. At this point the spine is then stiff. The healing time is then up to half a year or even longer, depending on the position and age of the patient.

It is possible that pain and reduced mobility remain despite good healing. In the case of uncomplicated fractures, healing usually proceeds very well and without consequential damage. This does not always require surgical treatment, but conservative therapy is sufficient.

This usually includes sufficient protection and immobilization with an orthosis, such as a corset. In this way, healing can take place without disturbances. The duration of healing of a vertebral fracture can vary greatly.

Many factors such as age, extent of the injury and also the subsequent treatment influence the recovery. A stable vertebral fracture, which often occurs in the course of overstrain and osteoporosis, usually does not endanger the nerve fibers of the spinal cord. Nevertheless, it causes pain for the patient and movement is also significantly restricted.

These vertebral fractures are usually first treated conservatively, i.e. without surgery. In addition to pronounced and sometimes prolonged bed rest, the symptoms are treated with painkillers. In the further course of the treatment, this also facilitates physiotherapy.

By means of targeted physiotherapy, the patient receives instructions for several weeks on how to behave in a way that is gentle on the back and learns exercises like in back school, so that the muscles can also be trained at home. After 2 – 4 weeks, these exercises are then performed on an outpatient basis. In some cases it is also recommended to wear a corset for 6 – 8 weeks.

It prevents wrong movements and at the same time the break can heal in peace. A cervical support (cervical collar) is necessary for cervical vertebra fractures. It can therefore take 2 – 3 months before the spine is fully able to bear weight again.

With unstable fractures, on the other hand, there is a risk that parts of the fracture will constrict the nerve root in the spinal canal, resulting in neurological deficits such as paralysis. Therefore, surgery is recommended without delay. In such an operation, the unstable vertebral body is bridged and sometimes additionally stiffened.

This prevents a possible constriction of the nerves. Metal plates and/or screws are often used for stabilization, which is why a longer healing phase follows after this procedure. Nevertheless, movement can be resumed after a few days of bed rest, as the spine is stable enough for everyday stress.

Only in the case of cervical vertebral fractures is an additional cervical support used. The patient can leave the clinic after one week. Further treatment then usually takes place in a specialized rehabilitation center. The fractures are completely healed after about 6 to 9 months. Usually the screws and metal plates remain in the body for a year, but in some cases they remain for life.