Trauma:

Types of Trauma:

Traumatic injuries to the neck and back can be divided into several types based upon the tissues which are injured, where they are damaged, and the severity of the injury.¹

Acute Fractures (Broken Bones in the Spine:

The most severe of the injuries involve an acutely broken bone with instability (abnormal movement). These most commonly occur following high speed injuries. Motor vehicle accidents and diving accidents commonly cause acute spinal fractures. Spinal fractures can occur in the neck (cervical spine), mid-back (thoracic spine), or low back (lumbar spine). They are most common in the neck.

Neck fractures (broken necks) have the greatest chance of being unstable and of causing a spinal cord injury. Spinal cord injuries caused by high velocity trauma to the neck can cause complete or incomplete quadriplegia (loss of all or some of the movement and feeling in the arms and legs). Most of these fractures are emergencies and they often require immediate surgery to save as much function as possible.


Acute lumbar fractures are less common but may occur with falls. Some are stable (not unstable) while others are unstable. The unstable fractures require surgery in most cases while the stable ones can be treated with bracing and conservative care. Thoracic fractures are the least common and occur only with the most severe injuries (such as high speed motor cycle accidents). Many, fortunately are stable, do not cause spinal cord damage. Stable fractures can be treated conservatively. If there is a nerve injury (such as paraplegia), emergency surgery is needed to salvage function.


Chronic Fractures:

Occasionally, one can have an old fracture that did not cause problems. A second injury can then cause the old fracture to become symptomatic. This most frequently occurs in the low back. In youth, one can break the back portion of a vertebral bone (a spondylolysis). This can go unnoticed for a lifetime, or after many years have passed, a smaller injury can cause symptoms. These are treated with medications, exercise, injections (epidurals, and selective blocks), and occasionally surgery (see lumbar fusion).

Instability without a Fracture:

Sometimes, severe injury will not cause a fracture but will still cause spinal-cord damage. This happens when the ligaments that tie the bones together are torn. These can be among the most dangerous of injuries since x-rays do not show the problem. If there are severe symptoms following an injury, a more careful examination is needed. X-rays can be done in several positions to see if there is abnormal movement. An MRI will often show the problem. The neck is most commonly damaged in this way and the result can be quadriparesis or quadriplegia (partial or complete loss of movement in the arms and legs). Unfortunately, surgery is usually needed for these injuries.

Soft Tissue Injuries:

Most spinal injuries do not cause broken bones, but rather damage the soft tissues. The soft tissues include the muscles, ligaments, and discs (see Sprains and Strains). Whiplash is one kind of sprain/straining injury. It is common after motor vehicle accidents, especially rear-end collisions. Even relatively minor accidents can cause severe symptoms. Almost all of these injuries can be treated without surgery. Analgesics (for example Motrin and Naprosyn), physical therapy, heat or cold, exercise, and occasionally a brace may help. Chiropractic and acupuncture can be extremely helpful as can other treatments such as biofeedback, hypnosis, Reiki therapy, and Pranic healing. It can take years for these to recover and the symptoms occasionally never resolve.

Our Web Site:

Please feel free to look around our web site. You will find a great deal of information on injuries to the spine and their treatment. If you have a serious spinal injury you should not rely on this or any other web page. Call 911, call your doctor, or go directly to an Emergency Room.

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¹This web page is not intended to be a complete discussion regarding spinal trauma. Injuries to the spine are both serious and complex. Do not rely on this web page for your treatment. If you have severe spinal injuries call 911 or call your doctor. If you want, call us and schedule an appointment. If you have had a spinal injury, we will see you immediately.






The information in this site briefly describes issues related to medical treatments, and has been licensed by from Northern California Neurosurgery Medical Group, Inc., who is solely responsible for said content.  This web site is not a substitute for good medical care or for a consultation with a spine specialist. It should not be used to plan your treatment. The well considered advice of a specialist who has personally examined you is always superior to even the best internet pages.


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Last modified: 07/27/08