Vertebral fractures are classified according to their cause, location, and stability:

1. By cause:
   • Traumatic vertebral fracture: Due to direct injuries, such as falls from great heights or traffic accidents.
   • Pathological vertebral fracture: Due to bone weakness caused by osteoporosis, tumors, or infections.
2. By location:
   • Cervical fractures: In the area of the cervical spine.
   • Thoracic fractures: In the area of the thoracic spine.
   • Lumbar fractures: In the area of the lumbar spine.
3. By stability:
   • Stable fractures: No risk to the spinal cord or the stability of the spine.
   • Unstable fractures: Risk of spinal cord injuries or spinal instability.

The causes of a vertebral fracture can be divided into traumatic and pathological factors:

- **Traumatic causes:**

- High-energy accidents such as falls, sports injuries, or traffic accidents.

- Low-energy trauma in patients with osteoporosis.

- **Pathological causes:**

- Osteoporosis, which reduces bone density and stability.

- Tumors that weaken the vertebral body, e.g., metastases.

- Infections such as spondylodiscitis.

- **Risk factors:**

- Age, lack of exercise, and a calcium-poor diet increase the risk of pathological fractures.

The symptoms depend on the severity of the fracture and possible involvement of the spinal cord:

- **Pain:**

- Localized, often severe pain at the fracture site, which increases with movement.

- Radiating pain in arms, legs, or the chest area.

- **Movement restrictions:**

- Difficulties in turning or bending the spine.

- **Deformities:** Visible misalignments, e.g., a hunchback (kyphosis).

- **Neurological deficits:**

- Numbness, tingling, or paralysis in case of spinal cord compression.

- **General symptoms:**

- In pathological fractures, often accompanied by fatigue or weight loss.

The diagnosis is made through a combination of medical history, clinical examination, and imaging techniques:

- Medical History:

- Assessment of the accident mechanism or underlying disease.

- Clinical Examination:

- Palpation of the spine for tenderness and checking for misalignments.

- Neurological tests to assess spinal cord or nerve root damage.

- Imaging:

- X-ray: For initial diagnosis of fractures and assessment of stability.

- CT: Detailed representation of bony structures and fracture lines.

- MRI: Assessment of soft tissues, spinal cord, and tumor infiltration.

- Bone Density Measurement:

- For diagnosing osteoporosis as an underlying cause.

Conservative Therapy

Stable fractures or minor injuries can often be treated conservatively:

• Immobilization and Relief:
  • Use of orthoses or corsets to stabilize the spine.
  • Avoidance of heavy physical strain.
• Pain Therapy:
  • NSAIDs: To relieve pain and inflammation.
  • Stronger analgesics for acute pain.
• Physiotherapy:
  • After the acute phase subsides, to restore mobility and muscle strength.
• Treatment of the Underlying Condition:
  • Osteoporosis therapy with calcium, vitamin D, and bisphosphonates.

Surgical Therapy

Unstable fractures or those with neurological deficits often require surgical treatment:

• Decompression:
  • Exposure of the spinal cord or nerve roots in case of compression.
• Stabilization:
  • Use of screws, plates, or implants to restore spinal stability.
• Kyphoplasty or Vertebroplasty:
  • Minimally invasive procedures where the vertebral body is stabilized by injecting bone cement.
• Tumor Treatment:
  • Removal of tumor tissue or stabilization of the vertebra in pathological fractures.

To prevent vertebral fractures and support recovery, the following measures are recommended:

1. Promote bone health: Adequate intake of calcium and vitamin D as well as regular exercise.
2. Fall prevention: Adapting the living environment and training balance skills.
3. Osteoporosis therapy: Early treatment of osteoporosis to prevent fractures.
4. Ergonomic stress: Gentle lifting and carrying in everyday life and work.
5. Regular check-ups: Especially for at-risk patients for early detection of bone weakness.