Broken Vertebrae

[Joy3888]

I am currently living in Eastern Europe in a country where the medical care is sub par.  A very good friend of mine from this area recently (and mysteriously) broke the last vertebrae in his spine (down near his tailbone).  He says the x-rays show that the vertebrae is broken in two places and the "tail" of it is just floating about 5mm away from the rest of his spine.  

This man is very active (was training for a marathon), relatively young (30), extremely careful with his health (good diet, no smoking or drinking) and had no major accidents before the pain began.  The only advice he has received from his doctors is to get cortisone shots or have the vertebrae fused together, but they have not offered a back brace or any other treatment.  My friend is horrified at the thought of spending the rest of his life off of running (as the doctors here tell him) and would very much like to heal more quickly.  Is there any advice I can give him or specific treatments that he can request from his doctors?  

My other concern is WHY the bone broke.  I have asked him to get some bone density screenings and cancer screenings, but can the vertebrae just snap from regular life (or running) in a healthy man?

[Adam Tanase, D.C.]

It sounds as if his diagnosis is spondylolysis.

As active as he is, he's a likely candidate for this type of stress fracture. If you do some research online for "spondylolysis," you'll see why this happened to him.

There's no ignoring this type of injury for athletes. Conservative treatment measures are aimed towards letting the fracture heal on its own. This includes wearing a brace and participating in physical therapy exercises. Any activity that extends the back is strongly discouraged.

The other (and last) option is surgical repair. Even with that, however, the athlete likely won't be returning to his activities for 8-12 months.


Adam Tanase, D.C.
www.drtanase.com

[abbs01]

I was also looking for some advice on a fractured vertebrae. About 3 months ago, after moving some furniture my lower back was in severe pain. After being put in the hospital and going through numerous mri, ct scans, colonoscopy, and ultrasounds, they discovered I had a fratured vertebrae. (L5). About 6 weeks ago I went to a spine specialist who put me ina brace. He told me it would limit movement and aleviate the pain. But I've been wearing the brace for 5 weeks now and the pain is still the same as it was 3 months ago. I have been on pain medication for 3 months and am tired of it. But any time I try to go without the meds, I end up in tears from the pain. So I'm just curious as to why there is still so much pain after having wore the brace for 5 weeks? And if it isn't healed, why? And what happens next? When the dr showed me the ct scan, he said that there was only a small portion of the vertebrae that wasn't fractured, and that it could possibly break in two completely. Is this possibly what happened? Thank you for any insight you can give me.

[Adam Tanase, D.C.]

Assuming he does in fact have spondylolysis, here is a web link that demonstrates exercises: http://tinyurl.com/coq6uq

Swimming is actually one of the exercises that therapists often recommend for athletes suffering from spondylolysis/spondylolisthesis.  

The back brace is designed to limit spinal extension... Through limiting this motion, the fracture has a better chance of healing on its own. (Much like if you broke your wrist, the bone won't heal as well -- if at all -- without a splint/cast.)

A conservative time frame may be anywhere from 4-8 months, depending on his activity level, and if/how long it takes the fracture to mend on its own.

For an additional point of view, you might consider addressing your question to Dr. Michael Gross in the Orthopedic Sports Medicine forum here on MedHelp.


Adam Tanase, D.C.
www.drtanase.com

[Joy3888]

Thank you for your response, you are providing some much needed mental relief to my friend.  Do you have any links to physical therapy exercises that are related to this condition and the broken vertebrae?  Currently he is swimming several times a week as a substitute but he can't bear to do much else.  Is he jeopardizing his spinal health swimming laps with the fractured vertebrae?

As to a back brace, is this something that is necessary to aid in his healing or is he alright maintaining his normal routine (which involves a lot of walking as means of transportation) without one?

Also, you said an 8-12 month break from athletics WITH surgery, is there a time frame for someone hoping to just heal on his own?