KidsMD Health Topics

Spinal Fracture

  • Overview

    Spinal cord fracture

    A spinal cord fracture is a break to the cervical, thoracic and/or lumbar vertebrae.

    The spinal column is made up of many individual bony rings called vertebrae, joined together by muscles and ligaments. Flat, soft intervertebral discs separate and cushion each vertebra from the next.

    Because the vertebrae are separate, the spine is flexible and can bend. Different regions of the spinal column have different names:

    • The cervical vertebrae are those situated around the neck.
    • The thoracic vertebrae are those situated in the chest region.
    • The lumbar vertebrae, along with the sacrum, make-up the lower back.

    The spinal column houses the spinal cord, which consists of nerves that carry and receive signals to and from the arms, legs, and many internal organs.

    How Boston Children's Hospital approaches spinal fractures

    Children's Spinal Program in nationally and internationally known for its innovation and leadership, offering the latest diagnostic and treatment approaches.  Our physicians with the Spinal Program see more than 6,000 outpatients and perform more than 300 spinal operations.

    SCI requires emergency medical attention on the scene of the accident or injury. This is accomplished by dialing 9-1-1 or your local emergency #. The SCI requires the child to be immobilized in the head and neck areas to prevent movement.
    Children's Hospital Boston
    300 Longwood Avenue
    Hunnewell 314
    Boston MA 02115
     fax: 617-730-0675

    Our Spinal Program offers the latest diagnostic and treatment approaches, some of which were developed at Children's Hospital Boston.
    Boston Children's Hospital
    300 Longwood Avenue
    Fegan 2
    Boston MA 02115

    Boston Children's Hospital at Waltham
    9 Hope Avenue
    Waltham MA 02453
    Boston Children's Hospital at Lexington
    482 Bedford Street
    Lexington MA 02420
    Boston Children's North
    10 Centennial Drive
    Peabody MA 01960
    Boston Children's Physicians South
    Stetson Medical Center
    541 Main Street
    Weymouth MA 02190
  • In-Depth

    What causes a spinal fracture?

    There are many causes of spinal fractures in children. The more common injuries occur when the area of the spine or neck is bent or compressed as in the following:

    Spinal fracture

    • Birth injuries, which typically affect the cervical vertebrae (in the neck area)
    • Motor vehicle accidents (where your child is either riding as a passenger in the car or is struck as a pedestrian)
    • Sports injuries
    • Diving accidents
    • Trampoline accidents
    • Violence (gun shots or stab wounds)

    What are the symptoms of a spinal fracture?

    Your child may have varying degrees of symptoms, associated with the severity and location of the fracture and whether or not the spinal cord has been compressed. A severe compression fracture may involve the spinal cord or nerve roots, as they are draped over the sudden angulation of the spine. This may cause severe pain, a hunched forward deformity (kyphosis) and/or paralysis. Other symptoms include:

    • Pain in the affected area (from mild to severe)
    • Swelling
    • Inability to walk or move normally
    • Deformity or an unnatural angle in the area

    If you suspect a spinal injury, call for emergency help and do not attempt to move your child. Medical personnel need to determine the extent of the damage as soon as possible. Immobilize your child's head, neck and spine by padding them with towels, blankets, or jackets.

  • Tests

    Your child's physician will make a diagnosis with physical examination and diagnostic tests. During the examination the physician obtains a complete medical history of your child and asks how the injury occurred.

    Diagnostic procedures include:

    • X-rays - a diagnostic test, which uses invisible electromagnetic energy, beams to produce images of internal tissues, bones, and organs onto film. This test is used to measure and evaluate the curve. And may also include:
    • Computerized tomography scan (Also called a CT or CAT scan.) - a diagnostic imaging procedure that uses a combination of x-rays and computer technology to produce cross-sectional images (often called "slices"), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays and may help the doctor determine what type of fracture your child has.
    • Magnetic resonance imaging (MRI) - a diagnostic procedure that uses a combination of large magnets, radiofrequencies, and a computer to produce detailed images of organs and structures within the body. This test is done to rule out any associated abnormalities
  • Specific treatment for a fracture will be determined by your child's physician based on:

    • Your child's age, overall health, and medical history
    • Extent of the fracture
    • Your child's tolerance for specific medications, procedures, or therapies
    • Expectations for the course of the fracture
    • Your opinion or preference

    The goal of spinal fracture treatment is the restoration of normal length and alignment of the vertebrae, and avoidance of motion between the fracture fragments.

    Treatment at Boston Children's Hospital may include some combination of the following:

    • Brace - immobilizes the injured area to promote bone alignment and healing to protect the injured area from motion or use. Bracing helps reduce acute pain by immobilizing the fracture and helps reduce the eventual loss of height and in angulation from the fracture. Immobilization of a cervical spine compression
    • Fractures usually involve the use of a rigid collar.
    • Medication (for pain control)
    • Reduction - involves realignment of the fractured bone. This can be done through an incision made into the fracture site (open reduction) or by external manipulation without an incision (closed reduction)
    • Traction - the application of a force to stretch certain parts of the body in a specific direction. Traction consists or pulleys, strings, weights, and a metal frame attached over or on the bed. The purpose of traction is to stretch the muscles and tendons around the broken bone to allow the bone ends to align and heal.
    • Surgery - required to put certain types of broken bones back into place. Occasionally, internal fixation (metal rods or pins located inside the bone) or external fixation devices (metal rods or pins located outside of the body) are used to hold the bone fragments in place to allow alignment and healing.

    Long-term outlook for a spinal fracture

    With proper immobilization and rehabilitation including physical therapy and exercise, most children can expect to make a full recovery from a spinal fracture.

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