Spinal Fractures and Trauma
A spinal fracture is a break in one or more vertebrae — the bony building blocks of the spine.
What are Spinal Fractures?
A spinal fracture is a break in one or more vertebrae — the bony building blocks of the spine. Spinal fractures range from minor compression fractures that may cause localised pain but no neurological injury, to unstable fracture-dislocations that can cause paralysis and require emergency surgical stabilisation.
Spinal fractures are common injuries, with vertebral compression fractures representing one of the most prevalent fragility fractures in older Australians with osteoporosis. Traumatic spinal fractures from motor vehicle accidents, falls, and sporting injuries are also common and constitute an important proportion of the work performed by neurosurgeons in Melbourne.
At One Brain and Spine, our neurosurgeons provide urgent and elective assessment and management of spinal fractures — from emergency surgical stabilisation through to minimally invasive vertebral augmentation procedures (kyphoplasty and vertebroplasty) for osteoporotic compression fractures.
Types and Causes of Spinal Fractures
Osteoporotic Compression Fractures
The most common type of spinal fracture, occurring in patients with osteoporosis (reduced bone density). The weakened vertebral body collapses under normal or minor loads — sometimes occurring without any identifiable trauma. Osteoporotic compression fractures most commonly affect the thoracic and upper lumbar spine and cause sudden onset, severe localised back pain. They are a major source of pain and disability in older Australians.
Traumatic Fractures
Fractures occurring as a result of significant trauma — including motor vehicle accidents, falls from height, sporting injuries, and diving accidents. These fractures can affect any spinal level and range from stable fractures (where the spinal column remains intact and neural structures are not at risk) to unstable fractures (where the structural integrity of the spine is compromised, risking spinal cord or nerve root injury).
Pathological Fractures
Fractures occurring in bone weakened by disease — most commonly metastatic cancer, primary bone tumour, or infection. Pathological fractures can occur with minimal trauma and should be suspected when a vertebral fracture occurs without adequate trauma, particularly in patients with a known malignancy.
Stress Fractures (Spondylolysis)
Fatigue fractures of the pars interarticularis — occurring predominantly in young athletes involved in extension-loading sports. See the Spondylolisthesis page for more information.
Symptoms of Spinal Fractures
Pain
Sudden onset, severe localised pain at the fracture level is the most common presenting symptom. In osteoporotic compression fractures, the pain is typically well-localised to the mid-back or lower back and is exacerbated by any movement or weight-bearing. In traumatic fractures, pain is severe and the mechanism of injury is usually apparent.
Neurological Symptoms
Spinal fractures that compromise the spinal canal can cause neurological injury — ranging from nerve root compression causing radicular pain and weakness, to partial or complete spinal cord injury causing paralysis and loss of sensation below the injury level.
Urgent and Emergency Symptoms
Seek emergency medical attention immediately for any of the following following spinal trauma or vertebral fracture:
- Weakness or paralysis of the arms or legs
- Loss of sensation in the limbs or trunk
- Loss of bladder or bowel control
- Severe neck pain after trauma — particularly if associated with any neurological symptoms
- Inability to move due to pain after a fall or accident
How are Spinal Fractures Diagnosed?
Diagnosis of spinal fractures requires urgent imaging. At One Brain and Spine and through the Melbourne hospital network, our neurosurgeons have access to comprehensive spinal imaging for emergency assessment:
- CT scan of the spine — the first-line investigation for suspected traumatic spinal fracture; rapidly demonstrates fracture morphology, alignment, and canal compromise
- MRI — essential for assessing spinal cord, nerve root, and ligamentous injury that is not visible on CT; also used to identify fresh versus old osteoporotic compression fractures
- X-ray — an initial screening investigation in the emergency setting, though CT is superior for fracture characterisation
- DEXA scan — bone density assessment in patients with osteoporotic compression fractures, essential for guiding osteoporosis treatment
Treatments
Non-Surgical Treatment
Stable fractures without neurological compromise can often be managed conservatively:
- Analgesia — adequate pain control is critical; includes paracetamol, NSAIDs, and short-term opioids for severe pain
- Activity modification and bracing — a spinal orthosis (brace) protects the fracture during healing and reduces pain
- Physiotherapy — graduated rehabilitation commencing when the fracture has stabilised
- Osteoporosis treatment — for osteoporotic compression fractures, treatment of the underlying bone density disorder is essential to prevent further fractures
Minimally Invasive Vertebral Augmentation
For painful osteoporotic compression fractures that do not respond to conservative management:
- Vertebroplasty — injection of bone cement (PMMA) into the fractured vertebral body under imaging guidance to stabilise the fracture and relieve pain
Surgical Fixation of Fracture
Like a long-bone fracture, stabilisation with screws and rods may be required in certain fractures. This is more common with traumatic fractures from as opposed to osteoporotic fractures. At One Brain and Spine, we utilise the latest in navigation and robotics to stabilise the fractures.
On occasions surgical fixation is supplemented by removal of the broken vertebra itself with replacement by an expandable cage to provide extra support and restore spinal alignment. This may be performed posteriorly, or via a lateral incision allowing access to the spine in a minimally invasive fashion. The options of surgery will be discussed with you during your consultation.
When is Surgery Required?
Surgical stabilisation is required for:
- Unstable fractures — where the spinal column's structural integrity is compromised and there is risk of progressive deformity or neurological injury
- Fractures with neurological deficit — urgent decompression and stabilisation when the fracture is causing spinal cord or nerve root compression
- Pathological fractures — reconstruction of the affected vertebra and stabilisation of adjacent levels
- Progressive kyphotic deformity — severe angulation at a fracture site causing chronic pain or functional impairment
Frequently Asked Questions — Spinal Fractures Melbourne
How long does a spinal compression fracture take to heal?
Osteoporotic compression fractures typically take 6–12 weeks to heal with conservative management. Pain usually improves significantly within this timeframe, though some residual discomfort may persist. Vertebroplasty or kyphoplasty can provide faster pain relief for fractures not responding to conservative management. On occasions the use of an external brace may be recommended.
Will a spinal fracture cause permanent damage?
Stable spinal fractures without neurological compromise generally heal well without permanent damage. Fractures causing spinal cord or nerve injury can result in permanent neurological deficits, particularly if treatment is delayed. Early, appropriate management is critical for neurological recovery.
When should I seek emergency care for back pain after a fall?
Seek emergency care immediately after a fall if you have severe back or neck pain, weakness or numbness in your limbs, bladder or bowel dysfunction, or any difficulty moving. Even in the absence of obvious neurological symptoms, a significant fall in an older person with osteoporosis warrants urgent medical assessment.
Why Choose One Brain and Spine for Spinal Fractures and Trauma in Melbourne?
One Brain and Spine is a specialist neurosurgical group practice in Melbourne, formed by three experienced neurosurgeons committed to the highest standard of spinal care. We offer the full spectrum of evidence-based treatments from conservative management through to the most advanced minimally invasive and endoscopic surgical techniques available in Australia.
- Specialist neurosurgeons — all fellowship-trained with subspecialty expertise in spinal surgery
- Latest surgical technology — robotic-assisted navigation, endoscopic techniques, and microsurgery
- Conservative-first approach — surgery recommended only when clearly indicated
- Multidisciplinary care — working with physiotherapists, pain specialists, and radiologists across Melbourne
- Transparent, patient-centred consultations — your diagnosis and all options explained clearly
- Privately insured patients welcome — all major health funds accepted