Pathological Fractures of the Spine

What are Pathological Fractures?

Pathological fractures are broken bones in an area already weakened by another disease, not by an injury. Some underlying diseases can weaken the spinal bones making them brittle and eventually causing a fracture or break in the bone. 

Diseases Causing Pathological Fractures

Common diseases that cause pathological fractures in your spine include:

• Osteoporosis: A condition in which your bone starts to deteriorate and becomes too porous.
• Cancer: An abnormal cell growth on the bones, eventually weakening them and causing a break.
• Osteomalacia: A disease that softens the bones through the deficiency of vitamin D, thereby negatively impacting calcium absorption.
• Osteomyelitis: A bacterial or fungal infection in the vertebral column. 
• Other potential causes can be: 

1. Noncancerous tumors and cysts (lumps or swellings) 
2. Osteogenesis imperfecta, also known as brittle bone disease (a genetic disorder)

Signs and Symptoms 

Pathological fractures may or may not have symptoms, but may include the following:

• Mild to severe pain near the fractured bone 
• Pain in your back, legs and arms
• Tenderness, bruising and swelling near the broken bone
• Tingling, numbness or weakness near the broken bone
• Numbness and/or weakness in your legs and/or arms

What If the Condition is Left Untreated?

If untreated, pathological fractures may lead to functional decline and a risk of disability. 

Diagnosis

The doctor will conduct a physical examination and evaluate your medical history followed by an X-ray, MRI or a CT scan depending on the need. Certain laboratory tests may be done to assess calcium levels, and a biopsy (examination of tissue) may help to determine the exact cause of the fracture. 

Treatment  

The treatment usually depends on the underlying medical condition. The initial treatment could be as simple as resting and avoiding the activities that stress the affected area. 

Other potential options are:

• Pain medications 
• Use of a cast, splint, plate or brace 
• Radiation therapy 

If the fractures are caused by a disease that makes them hard to heal, the doctor may opt for surgical procedures such as:

• Vertebroplasty or a kyphoplasty
• Internal fixation
• Spinal fusion

Your doctor will discuss with you the details of each procedure before the surgery.

Prevention 

The risk of fractures can be reduced with the following:

• Weight-bearing exercises regularly
• Adequate vitamin D and calcium
• Early treatment for underlying conditions
• Low-intensity or less demanding activities