Pathologic vertebral fracture

The human spine is formed by individual vertebrae and connective tissue discs in between. The vertebrae form the spinal canal. There are seven cervical, twelve thoracic, and five lumbar vertebrae. The intervertebral discs are the link between the individual vertebral bodies.

The little joints that link the vertebrae together are known as facet joints. They help to stabilize the spine and, together with the intervertebral discs, allow a certain degree of mobility of the spinal cord. The spinal canal should be wide enough to allow nerve roots to float freely in cerebrospinal fluid. The front border of the spinal canal is built by the vertebral bodies and intervertebral discs, the side by the intervertebral joints (facets) and back by the ligamentum flavum (yellow band) and vertebral arches. Discs consist of an outer fibrous ring (annulus fibrosus), which surrounds an inner gel-like center (nucleus pulposus). The spinal cord and nerve roots lie within the spinal canal. The spinal cord extends downwards approx. to the 1st lumbar vertebra. Below, only nerve roots are present in the spinal canal. At the level of the intervertebral disc the nerve roots pass through the neural root foramina to exit the spinal canal. The spinal cord and nerve roots conduct electric-like signals from the skin and joints to the brain, and process of movement is initiated from the brain to the muscles.

Bone fractures due to disease weakening the bone are called pathologic. This most common causes for pathologic fractures are cancer, osteoporosis and infection.

Acute compression of the spinal cord and/or nerve roots

Vertebral fracture

Total/partial paralysis and numbness from the site of the spinal cord damage downwoads

Pain, numbness and weakness in the limbs

Severe pain over the fracture

Depending upon the primary cause, neurologically intact patients with a stable fracture could be treated non-surgically.

Patients with signs of nerve root/spinal cord compression Neurologically intact patients with a potentially unstable fracture

To release the compressed nerve roots

To restore the protective function of the spine

Posterior decompression of the spinal canal + fusion