natural viagra for women south africa how long before sex do you take viagra new zealand how much is viagra at cvs singapore is viagra bad for you australia how long does cialis stay in your system singapore buy viagra online without prescription new zealand womens viagra over the counter hong kong viagra connect walgreens singapore viagra near me new zealand sex viagra tablets hong kong which is better cialis or viagra australia how long do the effects of viagra last south africa cialis canada australia viagra name singapore viagra for women online new zealand generic viagra india south africa buy generic 100mg viagra online new zealand viagra pill for females new zealand viagro new zealand where to find viagra australia main ingredient in viagra australia sports viagra boys singapore levitra or cialis which is better hong kong how long before sex to take viagra singapore viagra no prescription hong kong viagra pictures before and after hong kong long term si effects of viagra singapore buy cialis with priligy online new zealand viagra pills for sale hong kong viagra para hombre en australia kamagra oral jelly 50mg new zealand flomax and viagra australia roman viagra review hong kong cialis lilly south africa cialis contraindications singapore how long does a viagra last hong kong kamagra store coupon co hong kong is kamagra illegal australia how quickly does cialis work hong kong marley drug viagra australia levitra over the counter hong kong buy cialis pills singapore viagra by mail south africa viagra effects new zealand african viagra hong kong can i buy viagra over the counter at walgreens new zealand how much viagra should i take for fun singapore viagra over the counter walgreens new zealand priligy 30mg buy online new zealand viagra and afib hong kong kamagra utschland bestellen rezeptfrei australia taking cialis daily singapore viagra venta singapore buy kamagra 100mg australia kamagra for her singapore buy viagra canada australia can priligy be taken with viagra hong kong viagro singapore viagra wiki hong kong viagra f singapore cheap levitra south africa liquid cialis singapore purchase viagra south africa si effects of viagra in olr men new zealand www kamagra hong kong cialis website singapore emla cream or priligy singapore combining viagra and adrall australia viagra type pills south africa cialis for bph dosage australia propecia si effects reddit australia levitra over the counter hong kong viagra tablet australia rogaine and propecia hong kong kamagra fizzy tabs hong kong where to get viagra over the counter australia how long does viagra work for singapore off brand viagra australia xnxx viagra singapore acheter priligy singapore how effective is cialis new zealand cheap generic viagra hong kong viagra spray south africa kamagra perth new zealand watermelon natural viagra australia kamagra 100mg chewable tablet south africa how long before sex should you take viagra hong kong online pharmacy viagra singapore viagra pills near me new zealand does viagra make you last longer singapore dog on viagra new zealand what color is viagra south africa generic viagra coupon hong kong silnafil vs cialis new zealand viagra aths singapore cialis not working new zealand how long cialis last south africa what works like viagra hong kong venn viagra en australia generic viagra 100mg australia viagra dosage for 70 year old hong kong viagra discount coupons singapore how much does cialis cost australia pink viagra pill singapore viagra para hombre cvs new zealand cialis near me south africa teva 5343 vs viagra south africa women viagra australia cialis heartburn south africa viagra 100mg online in canada new zealand cialis 60 mg australia do pornstars take viagra australia que es cialis south africa viagra ingredients south africa viagra prices costco singapore female version of viagra singapore how often can i take viagra new zealand does viagra raise your blood pressure hong kong priligy buy online australia levitra or cialis which is better new zealand viagra use singapore 100 milligram viagra singapore is viagra bad for you australia viagra trial australia how does propecia work hong kong como funciona el viagra australia is viagra government fund hong kong viagra and adrall south africa viagra prescription new zealand priligy new zealand kamagra kamagra south africa cheap levitra south africa viagra sex pill hong kong can i buy priligy over the counter australia la viagra new zealand efectos la viagra south africa roman viagra review singapore cialis and viagra together reddit south africa viagra for women cvs australia low price cialis singapore where can i get viagra south africa female viagra amazon new zealand does viagra affect women south africa how long for viagra to take effect australia best viagra singapore sex viagra pills australia generic viagra prices australia canadian pharmacy cialis 20mg new zealand the prince family viagra prank new zealand silnafil vs cialis australia reddit priligy new zealand viagra timeline hong kong viagra drink australia female viagra otc hong kong what happens if girls take viagra singapore buy levitra australia how do you take viagra singapore kamagra en alcohol south africa cialis pills online new zealand viagra before and after pics south africa cialis commercial bathtub singapore over the counter viagra for women australia can i get viagra over the counter hong kong can you take 2 viagra pills at once new zealand cialis cost singapore viagra pill 100mg singapore get viagra hong kong what do viagra pills do hong kong stendra vs cialis australia how long does it take for cialis to start working hong kong when should you take cialis south africa fake viagra pills singapore viagra before and after pics hong kong cialis ad singapore viagra price canada hong kong taking cialis and viagra together australia can you take viagra every day hong kong viagra vs cialis forum new zealand what stores sell viagra south africa viagra benefits australia is kamagra illegal australia yellow viagra pill australia cialis 20mg daily singapore pastilla viagra para mujer south africa what to do when cialis stops working south africa cialis 5 mg tablet south africa does cialis make you bigger singapore mom helps son with viagra south africa how long does viagra stay in your system hong kong dog viagra south africa does medicaid cover viagra south africa discount cialis new zealand roman viagra new zealand what is better cialis or viagra hong kong taking half a viagra for fun singapore cialis 5 mg hong kong how to get viagra online singapore viagra half life new zealand viagra com south africa does walgreens sell viagra hong kong viagra and marijuana singapore levitra 10 mg film coated tablets australia cialis meaning new zealand nitroglycerin and viagra singapore levitra how does it work singapore orr viagra hong kong best online viagra new zealand does viagra australia how to get propecia new zealand cialis generic over the counter south africa viagra generic name singapore viagra gold australia what does viagra do to you australia amlodipine and viagra hong kong cialis 60 mg hong kong tipos viagra australia what is cialis used for singapore best herbal viagra singapore will viagra raise my heart rate south africa viagra forum australia cialis cvs hong kong how long does cialis stay in your system australia best time of day to take cialis for bph australia cialis brand name new zealand pills that look like viagra new zealand comprar kamagra online españa hong kong cheap viagra and cialis singapore best place to buy kamagra singapore sister gives brother viagra singapore viagra use australia strongest viagra pill singapore viagra prank hong kong how long does propecia take to work south africa flomax and viagra hong kong does cialis keep you hard after coming singapore does chewing up viagra work faster south africa is there a generic viagra new zealand viagra gif singapore orr cialis online australia viagra price comparison singapore how to buy cialis new zealand can you take viagra with antipressants new zealand priligy dapoxetine price australia online pharmacy viagra hong kong where can you buy viagra australia cialis daily si effects singapore is viagra covered by insurance new zealand viagra pill australia viagra and ibuprofen singapore viagra for men near me new zealand can you overdose on viagra new zealand viagra online no prescription south africa discount viagra australia where can i get viagra pills south africa what would happen if a woman took viagra new zealand buy kamagra tablets australia propecia prescription online south africa natural cialis singapore does viagra work after prostate surgery hong kong kamagra online south africa how was viagra discovered hong kong girl viagra hong kong generic viagra white pill australia can you take 2 viagra pills at once australia buy viagra canada hong kong viagra headache hong kong propecia generic name australia viagra aths australia kamagra 100mg oral jelly south africa cheap viagra online hong kong kamagra effervescent australia viagra vasodilator south africa viagra history singapore propecia 1mg new zealand viagra and blood thinners new zealand different types of viagra australia levitra for less new zealand buy kamagra 100mg generic viagra singapore viagra timing singapore priligy amazon singapore better than viagra australia viagra walgreens hong kong viagra finition hong kong viagra for men online new zealand cialis pills online singapore generic viagra no prescription australia female viagra porn australia average dose of viagra singapore does viagra increase heart rate south africa cialis vs viagra singapore what does viagra do to a woman singapore pastillas viagra singapore propecia hair loss australia does viagra increase penis size singapore healthy man viagra hong kong viagra over the counter cvs hong kong propecia over the counter hong kong can you get viagra over the counter singapore when does viagra patent expire hong kong does viagra lower blood pressure singapore combining viagra and adrall singapore cialis pill generic hong kong gas station viagra singapore viagra connect walgreens new zealand viagra generic name new zealand viagra injection singapore buy viagra without prescription singapore does viagra help with premature ejaculation south africa how much is viagra per pill new zealand cialis com south africa buy viagra australia cronadyn vs priligy hong kong viagra si effects new zealand otc female viagra south africa where to buy generic viagra hong kong viagra logo south africa cialis and viagra together new zealand pastilla viagra hong kong can i take viagra twice a day singapore what happens when you take viagra hong kong does cialis make you bigger hong kong buy viagra over the counter australia what is the shelf life of viagra south africa does cialis shrink an enlarged prostate australia propecia online singapore levitra vs cialis south africa roman cialis cost singapore how long does kamagra last in the body singapore how to get propecia singapore viagra before and after size australia viagra how long does it last south africa how to buy cialis singapore what color is viagra pill south africa can females take viagra pills south africa viagra in spanish south africa viagra pill 100mg australia can viagra cause heart attack south africa viagra online in india singapore viagra f south africa kamagra reviews singapore cialis and high blood pressure south africa kamagra eu hong kong how to get propecia singapore what would happen if a girl took viagra australia cialis precio australia how to get viagra to work australia statins and viagra south africa kamagra cheap online singapore cheap viagra and cialis hong kong female viagra home remedies hong kong viagra and beer new zealand buy viagra connect hong kong viagra price 2018 hong kong over the counter viagra cvs new zealand propecia hair growth hong kong buy kamagra online thailand australia when should you take viagra new zealand what is the normal dose of viagra hong kong how to get viagra australia is there an over the counter viagra singapore female version of viagra singapore sex viagra tablets for female south africa viagra benefits hong kong the prince family viagra prank south africa los viagras singapore viagra over the counter walgreens singapore benefits of viagra for men hong kong is viagra covered by health insurance hong kong andy levitre australia levitra pills south africa honey viagra hong kong how often can you take cialis 20 mg hong kong cheap kamagra pills south africa viagra com australia cialis for sale on amazon singapore i have atrial fibrillation can i use viagra hong kong literotica viagra australia how to take levitra south africa puedo comprar viagra en cualquier farmacia singapore viagra prices hong kong cheap viagra pills hong kong how to take cialis 20mg new zealand do you need a prescription for viagra in the us singapore viagra reviews hong kong female viagra walgreens singapore do you need a prescription for viagra in the us singapore how effective is viagra south africa knock off viagra australia can i buy viagra at walgreens australia what color is viagra singapore cialis back pain singapore viagra triangle chicago australia viagra in stores australia what was viagra originally used for south africa viagra half life new zealand viagra 150 mg pills new zealand how to make natural viagra with immediate effect australia cialis 25mg australia cialis otc new zealand bob dole viagra singapore viagra best price south africa what are the effects of viagra hong kong ajanta pharma kamagra hong kong cialis prostate south africa viagra dosage south africa do you need a prescription for cialis new zealand how viagra works hong kong black market viagra australia priligy dapoxetine price new zealand viagra 100mg cost south africa nizagara vs viagra new zealand propecia wiki new zealand viagra masculino new zealand does viagra always work singapore propecia hair growth australia levitra 20 mg hong kong female viagra over the counter hong kong levitra 20mg price south africa viagra sex new zealand cialis indication new zealand priligy tablets new zealand cialis uses australia cialis si effects with alcohol australia buy kamagra australia kamagra oral jelly ingredients australia can you take 2 viagra pills at once singapore best viagra alternative australia viagra over the counter cvs hong kong what does generic cialis look like new zealand how long for cialis to work new zealand before and after viagra use australia how expensive is viagra singapore does viagra work for women australia can i get viagra over the counter at australia propecia hair singapore viagra sex pill new zealand generic viagra canada singapore viagra for pulmonary hypertension hong kong viagra half life hong kong how long does 100mg viagra last new zealand cialis manufacturer coupon 2020 south africa pfizer viagra price singapore kamagra online australia viagra dosage australia does viagra make you harr singapore cialis sublingual singapore viagra with food australia what does viagra mean australia cialis 20 mg price cvs australia metoprolol and viagra south africa can you take viagra and cialis together australia cialis 5mg australia orr cialis online hong kong what does viagra do for women australia how long for viagra to kick in south africa what is levitra new zealand viagra for women new zealand recommend dose of viagra australia levitra dosage 40 mg south africa kamagra oral jelly forum hong kong viagra feminino new zealand goodrx cialis singapore buy viagra cvs new zealand viagra classification south africa viagra packaging singapore ecstasy and viagra new zealand how much is a viagra pill south africa cialis picture singapore can women take mens viagra australia how long will viagra last australia propecia hair australia viagra timeline australia where do they sell viagra south africa how long does viagra stay in your system singapore viagra prices costco singapore cialis cost new zealand is cialis safe new zealand varnafil levitra australia cialis blood pressure australia home ma viagra singapore viagra 100 singapore can i get viagra over the counter at walgreens australia viagra unr tongue hong kong kamagra soft tablets 100mg singapore cialis from canada to australia 60 mg cialis too much new zealand viagra sex australia women taking cialis australia viagra sex pill south africa cialis blood pressure singapore can a woman take half a viagra new zealand taking cialis hong kong cialis for men australia is cialis stronger than viagra australia kamagra jelly singapore average age of man taking viagra new zealand cialis vs viagra recreational use australia generic viagra prices singapore viagra discount australia erectile dysfunction viagra new zealand does cialis work on women south africa what does a generic cialis pill look like singapore does cialis work better than viagra hong kong long term effects of viagra new zealand another name for viagra south africa what is the normal dose of cialis south africa cialis south africa viagra pro hong kong cialis online without prescription singapore buy cialis online without prescription new zealand viagra with food singapore cialis pills online south africa viagra shelf life south africa what would happen if a girl took viagra yahoo answers hong kong generic viagra online for sale south africa taking viagra daily singapore red viagra australia kamagra gel mk australia kamagra south africa walgreens viagra price singapore efectos secundarios la viagra singapore cialis and bph australia viagra for men and women new zealand kamagra oral jelly new zealand what does viagra do to men singapore liquid viagra hong kong high blood pressure viagra new zealand does viagra make you horny australia blue viagra hong kong kamagra chewable review new zealand viagra 150mg singapore kamagra gold 100mg review new zealand viagra and heart disease new zealand buy kamagra review new zealand viagra dosage hong kong kamagra jelly gevaarlijk australia cialis pills for sale south africa taking viagra australia what is the generic for cialis singapore kamagra per nachnahme bestellen south africa kamagra online bestellen forum south africa is viagra prescription australia how to orr viagra online hong kong what does a viagra pill look like australia snorting cialis hong kong priligy cvs new zealand can you get viagra over the counter south africa kamagra opasnosti new zealand how long does viagra last australia discount cialis hong kong ajanta pharma kamagra south africa kamagra eshop singapore how long does it take for viagra to work south africa cialis price walgreens australia taking viagra and cialis together south africa nitroglycerin and viagra australia is there female viagra south africa lady viagra cvs south africa cialis for sale on amazon new zealand levitra and exercise hong kong viagra challenge hong kong priligy amazon south africa super kamagra australia buy propecia singapore fake cialis 20mg singapore viagra medication singapore generic cialis name south africa can you mix cialis and viagra singapore viagra meme hong kong male viagra pill singapore viagra and food south africa cialis erectile dysfunction australia paul thorn viagra australia nizagara vs viagra new zealand free cialis coupon 2020 hong kong when viagra doesnt work australia best viagra for men australia kamagra tabletta new zealand sertraline and viagra south africa what is better viagra or cialis south africa over the counter viagra walgreens australia is there a generic cialis available in the us singapore kamagra utschland singapore cialis 20mg daily south africa does cialis keep you hard after coming hong kong viagra stories south africa viagra cost hong kong topical propecia new zealand buying viagra in hong kong cialis headache australia cialis without a doctor prescription canada singapore cost of cialis 5mg singapore pfizer viagra price hong kong max dose viagra hong kong is kamagra illegal australia viagra cost per pill hong kong adrall and viagra reddit australia where to get cialis south africa can you take cialis daily new zealand viagra and cialis singapore que pasa si tomo cialis y no tengo relaciones singapore is cialis a controlled substance new zealand don venn viagra australia how long does it take for cialis to take effect australia can i get viagra over the counter at south africa over the counter viagra cvs new zealand is viagra free singapore generic levitra 20mg pills australia kamagra oral jelly buy singapore viagra without a doctor prescription canada singapore grapefruit and viagra australia kamagra tabletta south africa priligy pills hong kong levitra 10mg vs 20mg australia best way to take cialis hong kong is propecia safe australia cialis pills for sale singapore is cialis stronger than viagra singapore kamagra 100mg oral jelly ebay singapore viagra online india south africa viagra at new zealand reddit priligy south africa women taking cialis singapore cialis 40 mg singapore rogaine and propecia singapore how long does propecia take to work new zealand is viagra otc australia priligy cvs new zealand what is the normal dose of cialis singapore how to orr viagra australia don comprar priligy en australia viagra sex singapore kamagra shop 24 hong kong cialis online south africa viagra spray singapore cialis website australia cialis daily dosage australia propecia si effects reddit new zealand can i take 200mg of viagra south africa how much is viagra per pill singapore how do you get viagra new zealand how long for viagra to kick in south africa cialis alternative singapore how can i get viagra new zealand how much icariin equals viagra australia non prescription viagra hong kong does viagra make your penis bigger hong kong i have atrial fibrillation can i use viagra hong kong can i get levitra over the counter singapore viagra boys street worms south africa when viagra doesnt work diabetes singapore pink pill female viagra south africa propecia hair regrowth hong kong viritenz vs viagra singapore cialis 20 new zealand viagra does not work hong kong can u buy viagra over the counter south africa buy female viagra new zealand free cialis samples new zealand levitra or cialis which is better south africa is cialis over the counter singapore priligy and westoxetin hong kong cialis without a doctor prescription singapore sertraline and viagra new zealand average dose of cialis australia what is a viagra pill hong kong what color is viagra hong kong cialis tadalafil australia how to get viagra over the counter south africa cialis on line south africa how long does cialis take to kick in australia how long does cialis take to work south africa best time to take cialis new zealand what works better viagra or cialis new zealand viagra triangle south africa how to take viagra with water or milk singapore generic viagra reviews new zealand kamagra 100mg oral jelly silnafil singapore does alcohol affect cialis australia is there anything over the counter that works like viagra australia 200mg viagra reddit hong kong kamagra jelly price south africa can you take viagra if you have high blood pressure new zealand generic viagra canada hong kong female viagra effects singapore what's the difference between viagra and cialis australia is viagra bad for your heart singapore does viagra keep you hard after you come hong kong can you take viagra and cialis together singapore do you need a prescription for cialis hong kong how long does it take for viagra to take effect australia viagra online without prescription singapore how does levitra work hong kong kamagra oral jelly forum south africa where can i get viagra pills new zealand does sell viagra australia can women take propecia australia is 20mg cialis equal to 100mg viagra south africa cialis si effects with alcohol new zealand cialis dosage reddit south africa how long before sex do you take viagra hong kong cialis and high blood pressure singapore cialis 10 mg australia cialis lower blood pressure south africa cialis ingredients singapore viagra for men online new zealand the prince family viagra prank south africa free cialis samples south africa kamagra now closed down south africa what happens if a girl takes viagra hong kong viagra vio new zealand is 20mg cialis equal to 100mg viagra hong kong roman cialis south africa what is female viagra australia cialis not working first time south africa off brand viagra south africa cialis 10mg price south africa generic viagra silnafil singapore when should i take viagra singapore viagra near me australia buy kamagra oral jelly australia does viagra keep you hard after coming hong kong köp priligy singapore cialis com new zealand viagra essential oil south africa viagra triangle chicago australia herbal viagra amazon australia cialis 10 mg singapore does viagra affect women south africa what color is viagra new zealand what is female viagra singapore generic propecia singapore where to get viagra over the counter south africa is cialis a controlled substance new zealand levitra and exercise singapore propecia dosage hong kong goodrx viagra singapore cialis prostate singapore viagra original purpose south africa can you take viagra if you have high blood pressure singapore can i buy viagra at walgreens hong kong cost of cialis 5mg hong kong kamagra oral jelly ingredients singapore cialis for daily use new zealand kamagra next day livery australia over the counter viagra new zealand rhino viagra australia viagra online canadian pharmacy new zealand what color is viagra pill australia priligy review south africa kamagra oral jelly forum south africa cialis generic name new zealand levitra pills south africa what if a woman takes viagra south africa kamagra oral jelly where to buy singapore kamagra 100mg south africa levitra 10mg vs 20mg hong kong can you mix viagra and cialis singapore levitra or cialis which is better australia priligy online australia cheap viagra 100 canada south africa viagra in use singapore does walgreens sell viagra hong kong herbal viagra amazon south africa is viagra good for your heart south africa priligy viagra kombination new zealand women viagra cvs singapore viagra prescription australia kamagra oral jelly forum new zealand cialis tadalafil south africa does viagra make your penis bigger singapore levitra generic name south africa blue viagra hong kong buy generic cialis online australia viagra online canadian pharmacy australia what color is viagra pill hong kong viagra rx australia african viagra south africa how long does levitra last australia how long for propecia to work new zealand cialis best price new zealand what does cialis look like new zealand does viagra increase blood pressure new zealand what happens when a girl takes viagra hong kong viagra and nitrates australia mom help son viagra hong kong can diabetics take viagra australia how much viagra cost australia cialis tv commercial new zealand viagra without prescription singapore how to buy cialis new zealand how to treat back pain from cialis hong kong cialis versus viagra south africa foods that enhance viagra south africa womens viagra over the counter hong kong what is the shelf life of viagra south africa taking viagra for fun hong kong how soon after surgery can i take viagra south africa cialis 10mg price new zealand can you drink alcohol with cialis australia cialis si effects with alcohol south africa cialis amazon new zealand viagra how long south africa roman cialis new zealand viagra classification singapore viagra online no prescription hong kong kamagra online review new zealand does viagra really work singapore kamagra 100mg oral jelly silnafil south africa pussycat viagra hong kong kamagra chewable review south africa blue viagra pills australia how long for viagra to work australia andy levitre singapore buy kamagra review hong kong kamagra oral jelly si effects hong kong viagra price south africa whats viagra hong kong get cialis online singapore watermelon rind viagra hong kong nitroglycerin and viagra australia where to buy viagra in singapore can you snort viagra hong kong priligy buy online canada new zealand cialis si effects reddit australia viagra para hombre en south africa cialis manufacturer coupon lilly australia viagra condom new zealand taking kamagra singapore natural alternative to viagra south africa

Spinal Fracture

A spine fracture is a serious injury. Young men are the most frequent victims of a fracture of the spine caused by high-energy trauma from falls and traffic accidents. Neurological injury occurs in 16 -25% high-energy traumas. Most spine fractures occur in the mid or low back or at the juncture between the two and constitute a substantial risk of spinal cord injury and paralysis.

Many traumatic spine fractures can be treated with conservative measure including 4-12 weeks of immobilization and bracing. However, major fractures that cause instability, and those that involve the spinal cord and/or nerve roots will require prompt treatment to reduce the risk of further injury and to minimize long-term disability. Fractures are categorized by the pattern of injury. There are three categories of spine fractures:

1. Flexion – Fracture Pattern

Compression fractures

Compression fractures are the most common type. In a compression fracture the injury causes the vertebrae to collapse causing acute pain, usually severe.  Compression fractures involve a breakage of the front of a vertebra but not the back. These fractures tend to be stable meaning the bones will not move out of place. Most flexion fractures can be treated without surgery when the fracture is stable.  Vertebroplasty, injection of a cement material into the vertebral body, may shorten the recuperation.

Burst Fractures

When the trauma is in the right direction and forceful enough,  it can burst the bone sending bone fragments in all directions , including into the spinal column. Burst fractures are frequently unstable and increase the risk of long-term neurological damage. Unstable burst fractures are a medical emergency. They are treated with surgical decompression of the spine and stabilization of the fracture.

2. Extension – Fracture Pattern

Flexion-Distraction Fractures

Flexion-Distraction Fractures are often called “Chance Fractures” or “Seat-belt fractures”. They occur when traumatic forces pull the posterior portion of the vertebrae apart. This is often caused by a head – on collision where the chest is thrown forward, and the lower body is held stable by a seat belt. The trauma fractures the bone and may tear the ligaments. Severe back pain is the main symptom. This pattern may damage internal organs and be associated with other injuries.

If there is no damage to the ligaments, vertebral discs or spinal cord, extension fractures can be treated nonsurgical with bracing or casting for 3 months.  . Surgery may be necessary with significant kyphotic deformity, ligamentous injury, or neurologic signs or symptoms.

Rotation Fracture Pattern:

The most common rotation pattern is found in fracture – dislocation where the vertebra is displaced or dislocated and compresses the spinal cord. This is a very unstable injury that causes severe pain and when the spinal cord is involved, may produce numbness, tingling, weakness and even bowel and bladder dysfunction. This is a medical emergency. These fractures require stabilization with posterior spinal fusion and vertebrae realignment.

Symptoms of a spinal fracture

Symptoms vary depending on the location and type of fracture. The first symptom is pain and worsening of pain with movement. However, when the spinal cord is involved symptoms include numbness, tingling, weakness, bowel and bladder dysfunction, and paralysis.

Diagnosis

Emergency stabilization at the scene of an accident is necessary before transfer to the ER. Arriving at the ER, the trauma specialist will assess the extent of injuries, including breathing ability. The patient will be examined head to toe. X-rays will reveal the type and severity of the fracture. A CT scan will provide 3-D views to reveal all bone damage, and diagnose soft tissue injuries, and bleeding. An MRI with contrast will provide a clear view of damage to ligaments discs and the spinal.  The trauma doctor will conduct a neurological exam.

Treatment

Initially treatment will the focus on pain management and stabilization to prevent additional injuries. When there are other injuries, they will also be treated. When the fracture only affects the vertebrae, and the spine is stable , nonsurgical treatment with a brace or cast will be sufficient. Depending on the fracture pattern and stability, bracing and possibly surgery will be needed. 8-12 weeks of bracing may be required. Instrumentation and fusion are surgical procedures to treat unstable fractures.  Minimally invasive surgical procedures will be used to treat compression fractures