Vertebral fracture at the vertebral arch
The vertebral arch surrounds the spinal cord – and is thus located at a critical point: if it breaks, it can penetrate the spinal cord and cause paraplegia. In this respect, the indication for surgery is quite generous. In most cases, the vertebral arch is surgically screwed or plated. The screw or plate usually remains on the vertebral body and is not removed. As with other bone fractures, the duration of protection is 6-8 weeks.
Vertebral fracture at the spinous process
At the spinous process, ligaments and a part of the back musculature start. A fractured spinous process alone does not necessarily cause clinical symptoms. Only if a large number of fractured vertebrae are present does surgery become mandatory, as the stability of the back muscles is impaired.
After all, the muscle can no longer “hold on” anywhere when everything is broken ! However, the fracture of a single spinous process can still be treated conservatively. In addition to relief and physiotherapy, the most important thing is to take it easy until bone healing is complete after 6-8 weeks. However, a full loading capacity can only be expected after 3-4 months.
Vertebral fracture at the transverse processes
Factors that speed up the healing time after a vertebral fracture are, in addition to rest and bed rest, physiotherapy and rehabilitation. A corset also prevents harmful movements. In physiotherapy, the muscle apparatus is built up and the load is taken off the fractured vertebra.
Therefore, strengthening the back muscles is also an important part of the therapy after bone healing. However, the healing of the bone must be completed, otherwise the fracture could tear again, and the healing time could be extended again. Physiotherapy follows for a period of 3-4 months and is intended to alleviate symptoms and restore the range of motion. Blue: healthy vertebral body Red: fractured vertebral body
Factors that adversely affect healing
The duration of the healing process can be extended by a variety of factors. In addition to the usual surgical complications, the fracture can tear again due to lack of protection (so-called recurrence). Inflammation and abscesses can affect the healing rate.
In general, bones become more porous with age and heal more slowly. The formation of new bone cells in the bone no longer functions as well in an elderly patient as in a young one. Osteoporosis patients are particularly at risk: The altered bone structure leads to a greatly increased risk of fracture.
Screws or plates no longer hold as well in the bone, and the overall healing process is slower. Calcium deficiency, or the intake of estrogens (birth control pill) also cause reduced bone density. All these factors lead to a prolonged healing period after a vertebral fracture – regardless of the location.
