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Thoracic and Lumbar Fractures

A thoracic or lumbar spinal fracture is a serious injury. A thoracic fracture is a fracture of the upper back, while a lumbar fracture is a fracture of the low back. The most common cause of these injuries are motor vehicle accidents and a fall from a height. With these fractures, there is also an association of additional injuries due to the high energy involved. People with osteoporosis, tumors or other underlying bony conditions can develop pathologic fractures with normal activity. The most common symptoms of a spine fracture is severe pain and difficulty standing. Should the fracture compress the spinal cord or nerves, numbness, tingling, weakness or bowel/bladder dysfunction may occur.

Upon the onset of pain or injury at the accident scene the patient should be mobilized prior to transfer. Unsafe transfer can result in permanent and irreversible paralysis. Next physical examination, radio-graphic studies including x-rays and CAT scans are needed for diagnosis. Should the patient have a neurologic deficit, an MRI scan will be of benefit to evaluate the neural elements.

Treatment is based upon the designation of either a stable or unstable injury pattern. Generally a stable injury can be treated by immobilization (i.e. brace) and mobilization with physical therapy. Surgery may be required for an unstable injury. Additionally, injuries with neurologic deficit that have been exposed to large magnitudes of force resulting in severe disruption may require surgical care. There are two types of surgical procedures – stabilization and decompression.

  • Stabilization is a procedure that is intended to restore structural stability.
  • Decompression is a procedure that is intended to take pressure off of the spinal cord and nerve roots.

Whether the patient is treated with or without surgery, rehabilitation is often necessary. The goals of rehabilitation are to regain mobility, reduce pain and return the patient to an active life. The recovery of neurologic function is dependent upon the traumatic damage to the spinal cord/nerves, age of the patient , comorbidities and the result of surgical care.

To learn more about Dr. Cotler or to schedule an appointment, please call us on (713) 523-8884 or visit

Howard B. Cotler, MD, FACS, FAAOS is board certified and recertified in Orthopedic Surgery. He is a fellow of the American Academy of Orthopedic Surgery and the American College of Surgeons.

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