Makindo Medical Notes

A spinal fracture = break in one or more vertebrae. ⚡ Causes: trauma, osteoporosis, or pathological processes (tumour, infection). They range from minor wedge fractures → unstable cord-threatening injuries needing urgent surgery.

🔑 Key Causes

• Trauma 🚗: High-energy trauma (RTA, falls, sports).
• Osteoporosis 🧓: Vertebral compression fractures, especially thoracolumbar junction.
• Pathological 🦠: Bone weakened by tumour, metastases, infection (osteomyelitis, TB).

🩺 Clinical Presentation

• Pain: Severe focal back/neck pain, worse with movement.
• Neurological: Tingling, weakness, paralysis if cord/nerve compression.
• Deformity: Kyphosis, loss of height, malalignment.
• Mobility: Reduced activity, difficulty walking, fear of movement.

📸 Imaging

• 🩻 X-ray: First-line; must include C7/T1 in cervical trauma.
• 💻 CT: Best for bony detail; standard in trauma protocols.
• 🖥 MRI: Essential if neuro deficits, cord oedema, ligamentous injury, tumour suspected.

📊 Classification of Spinal Fractures

💊 Management Principles

• Conservative 🛏️: Stable fractures, no neuro signs → brace, analgesia, physio.
• Surgical 🛠: Unstable, neuro deficit, progressive deformity → decompression, fusion, vertebroplasty/kyphoplasty (for osteoporotic fractures).
• Rehabilitation 🤸: Multidisciplinary – physio, OT, psychological support, VTE prophylaxis, bone health optimisation (bisphosphonates, vitamin D, calcium).

🎯 Exam Pearls

• Odontoid peg fractures common in elderly falls → high non-union risk in type II.
• Hangman’s fracture = C2 pars → hyperextension (RTA, hanging).
• Compression = stable; Burst = unstable if canal compromise.
• Chance fracture = “lap belt injury”, often with bowel perforation.
• Always check for neurology + bladder/bowel symptoms in any spinal fracture.