A vertebral fracture is usually associated with major trauma or exposure to very high forces unless the vertebrae have been previously damaged by a reduction in bone density (osteoporosis/loss of bone mass) or other diseases (e.g. tumors or metastases in the vertebrae).
There are various forms of vertebral fractures: fractures of the vertebral body, the vertebral arch or fracture of the spinous processes.
Vertebral body fractures are divided into compression fractures, i.e. the vertebral body is squeezed together, burst fractures, i.e. the vertebral body has been crushed, and fractures involving separation of the front or back rim of the vertebral body. Almost half of all cases of vertebral fractures affect the lower dorsal spine and the upper lumbar spine.
Vertebral fractures can occasionally be completely symptom-free. As a rule, the affected part of the spine will be painful on pressure, percussion and compression. Gibbus deformity (sharp angulation) or a palpable gap in the row spinous processes is very rare. The range of movement of the spine is often restricted by pain, the patient adopts postural guarding and the muscles go into spasm. If the spinal cord is involved, the patient develops corresponding neurological disorders or even deficits e.g. paralysis, paraesthesia or unnatural reflexes below the injury. Depending on the site of the vertebral fracture and the degree of spinal cord injury, complete paraplegia may result in very severe cases.