Ask the Spine Surgeon
February, 2015 - Issue #124
Q: A few months ago I slipped and fell while hiking. I felt sore afterwards but didn't think any major damage was done and didn't seek medical attention. About a month later, I went into the doctor's office complaining of a nagging back pain. Surprise, surprise. I have a spinal fracture. What I thought was due to my age - or a kidney stone - was most likely the result of my tumble down a mountain. My doctor says that the facture is minor and that it could heal on its own. Is that true? I'd love to avoid surgery, but I don't want this to get worse.

Luck may be on your side! I'm guessing that your doctor provided you with an external brace, supplements like calcium and Vitamin D and pain medication, if necessary. These non-invasive treatments are our first response to the minor spinal fracture you describe here. I'm never one to jump into surgery, especially in a circumstance like this. There's a good chance that the fractured area can heal itself through immobilization and a nutritional boost.
If, after several weeks of bracing, you don't see improvement, then it's time to come in for a consult. Even minor spinal fractures can become more painful and troublesome over time, as fragments of bone can pinch and damage spinal nerves and the spinal cord.

If surgery is necessary, there's no reason to fear it. Depending on the location and gravity of your fracture, your procedure may include using a tiny balloon to move the fractured portion into the proper position, then sealing the fix with a specially-crafted polymethylmethacrylate, a paste-like material that rapidly hardens.
No matter what treatment is applied for your particular case, though, there are many positive commonalities. First, your incision will be minimal - often one inch in length or less. Second, because of my practice's specialty in minimally-invasive surgical procedures, you'll heal quicker and even go home the same day of your surgery. In fact, you'll be up and moving by the next day. My office also boasts infection rates near zero - significantly lower than regional, state and national averages. The point is this: If surgery is a must, it's not the end of the world. You'll be back to your pain-free self in no time.

But since we're on the topic, let's quickly discuss spinal fractures in general. No one likes a doctor who says, "I told you so," but I can't finish my reply to you without noting that it's always better to be safe than sorry.

If you or any of my readers experience backache after a car accident, fall, sports injury or even a terrible coughing fit, please seek the care of your physician or a spine specialist immediately. Spinal fractures - even minor ones - can lead to more pain, spinal deformation and more. And, of course, all of these issues become magnified as you age. A minor spinal fracture today can create breathing difficulties and even trouble eating "tomorrow."

In order to feel confident in your execution of everyday activities and to maintain ultimate mobility, take care of even the most minor spinal fractures right after they occur. The health and functionality of your back is worth the minor inconvenience.

Kapil Moza MD, FACS
Diplomate, American Board of Neurological Surgery
Dr. Moza's Santa Clarita office is conveniently located in Valencia. 805-497-3622
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