Burst Fracture - Causes, Symptoms, and Treatment

Burst Fracture: Causes, Symptoms, Diagnosis, and Treatment

A burst fracture is a serious type of spinal injury that occurs when a vertebra breaks under extreme force and collapses in multiple directions. Unlike simple compression fractures, a burst fracture causes the vertebra to shatter into several fragments, which can spread outward. This loss of structural integrity may reduce vertebral height and, in severe cases, place dangerous pressure on the spinal cord or nearby nerves.

Because the spine protects the nervous system, burst fractures are considered medical emergencies and require prompt evaluation and appropriate management.

What Is a Burst Fracture?

A burst fracture happens when intense vertical force is transmitted through the spine, causing the vertebral body to “burst” apart. The bone fragments may move backward into the spinal canal, increasing the risk of spinal cord or nerve injury. These fractures most commonly affect the thoracic and lumbar regions of the spine, where mechanical stress is greatest.

Causes of Burst Fracture

1. High-Energy Trauma

The most frequent cause of burst fractures is severe trauma, including:

• Road traffic accidents

• Falls from significant heights

• Sports-related collisions

• Industrial or workplace injuries

The spine absorbs more force than it can tolerate, resulting in vertebral failure.

2. Osteoporosis

In individuals with reduced bone density, such as those with osteoporosis, even low-impact trauma or minor falls can cause the vertebrae to fracture and collapse.

Symptoms of a Burst Fracture

Symptoms vary depending on the severity of the fracture and whether neurological structures are involved. Common signs include:

1. Severe Back Pain

Intense, localized pain at the site of injury is the most common symptom and often worsens with movement.

2. Neurological Deficits

If bone fragments compress the spinal cord or nerves, symptoms may include:

• Weakness or numbness in the arms or legs

• Tingling or loss of sensation

• Difficulty walking or maintaining balance

• Loss of bowel or bladder control

• Partial or complete paralysis in severe cases

3. Spinal Deformity

Some patients may develop abnormal spinal alignment, such as increased curvature or visible deformity at the injury site.

Diagnosis of Burst Fracture

Accurate diagnosis is crucial for determining stability and neurological risk.

1. Clinical Examination

The healthcare provider evaluates pain levels, spinal alignment, and neurological function, including muscle strength and sensation.

2. Imaging Studies

• X-rays help identify vertebral collapse

• CT scans provide detailed images of bone fragments and fracture patterns

• MRI scans assess spinal cord, nerve involvement, and soft tissue damage

These imaging tools guide treatment decisions.

Treatment Options for Burst Fracture

Management depends on fracture stability, neurological involvement, and overall patient health.

1. Conservative Treatment

Used when the fracture is stable and neurological function is intact. This may include:

• Pain control medications

• Spinal bracing to limit movement

• Activity modification and rest

• Gradual introduction of physical therapy

2. Surgical Treatment

Surgery is required in cases of:

• Unstable fractures

• Progressive spinal deformity

• Spinal cord or nerve compression

• Severe or worsening neurological symptoms

Surgical procedures may involve spinal decompression, realignment, and stabilization using screws, rods, or bone grafts.

3. Rehabilitation

Rehabilitation is vital after both conservative and surgical treatment. A structured program focuses on:

• Restoring mobility and strength

• Improving posture and spinal stability

• Preventing complications such as stiffness or muscle weakness

• Gradual return to daily activities

Recovery and Prognosis

Recovery from a burst fracture varies widely. Stable fractures may heal well with conservative care, while severe injuries may require long-term rehabilitation. Early diagnosis, appropriate treatment, and consistent physiotherapy significantly improve outcomes. Some patients regain full function, while others may experience lasting limitations, depending on the extent of nerve involvement.

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Frequently Asked Questions

What is the most common site of a burst fracture?

Burst fractures most often occur in the thoracic and lumbar spine, particularly at the junction between these regions, due to high mechanical stress.

Can someone fully recover from a burst fracture?

Yes, recovery is possible. Stable fractures without neurological damage often heal well. More severe fractures may require surgery and extended rehabilitation, but many patients regain good functional ability.

What is an example of a burst fracture?

A classic example is a person involved in a high-speed car accident who sustains a spinal injury, causing the vertebra to shatter and compress the spinal canal.

How is a burst fracture named?

Burst fractures are typically named based on their location, such as a thoracic burst fracture or a lumbar burst fracture.

About the Author

Dr. Ajay Shakya, MPT, Certified Manual Therapist
Dr. Ajay Shakya is an experienced physiotherapist with over a decade of clinical practice in rehabilitation and holistic healthcare. He holds a Master’s degree in Neurological Physiotherapy and a Diploma in Nutrition, specializing in spine care, neurological recovery, and functional rehabilitation.

Disclaimer:
This article is intended for educational purposes only and should not be considered a substitute for professional medical advice. Always consult a qualified healthcare provider for diagnosis and treatment.