Burst fractures

A burst fracture is a serious injury, usually from a car accident or a hard fall. Fast, expert evaluation protects the spinal cord and nerves, and many patients recover well.

What Is a Burst Fracture?

A burst fracture happens when a high-energy force crushes a vertebra, breaking it in several directions. Unlike a simple compression fracture, both the front and back of the vertebra break, and bone fragments can be pushed backward into the spinal canal.

Burst fractures most often happen where the mid-back meets the lower back (around T11 to L2). Depending on how much bone shifts and whether the spinal cord or nerves are affected, treatment ranges from a brace to surgery to stabilize the spine.

What’s Happening in Your Spine

• The vertebra breaks into pieces from strong vertical force
• Fragments may push into the spinal canal and press on the spinal cord or nerves
• Ligaments at the back of the spine may also be torn, which makes the injury unstable
• The spine may lose its normal alignment and develop a forward bend

Symptoms

• Severe back pain after an accident or fall
• Pain that worsens with movement
• Numbness, tingling or weakness in the legs
• Bladder or bowel problems in more severe injuries

This is an emergency: After a serious accident or fall, don’t move the injured person if a spine injury is possible. Call 911.

Causes and Risk Factors

• Motor vehicle accidents
• Falls from height, including from ladders and roofs
• Sports and recreational injuries
• Weakened bone from osteoporosis or cancer can make fractures more likely

How We Diagnose Burst Fractures

• Emergency evaluation: a full neurological exam of strength, sensation and reflexes
• CT scan: the key test, showing the fracture pattern and how much bone is in the spinal canal
• MRI: shows ligament injury and any spinal cord or nerve compression
• Standing X-rays: for patients treated in a brace, to make sure the fracture stays aligned

Treatment Options

Non-surgical treatment

Many burst fractures in patients with normal nerve function and intact ligaments are stable and can heal in a custom brace, with close follow-up X-rays to make sure the alignment holds.

When surgery makes sense

Surgery is recommended when the fracture is unstable, when bone fragments press on the spinal cord or nerves, or when there is significant collapse or misalignment. In these cases, surgery can often correct the problem:

• Burst fracture repair: screws and rods stabilize the spine and restore alignment, often through minimally invasive incisions
• Decompression: removing bone fragments pressing on the spinal cord or nerves
• Spinal stabilization after trauma for complex injuries

Why Choose Dr. Betsy Grunch for Burst Fractures

• Duke-trained: neurosurgical residency and spine research fellowship at Duke University School of Medicine, where she received the Spine Young Investigator Award
• Experience you can count on: in practice since 2013, performing 400 to 600 surgeries a year and more than 5,000 procedures over her career
• Trauma and minimally invasive expertise: experience treating serious spine injuries, including stabilization through smaller incisions when appropriate
• The right treatment for you: board-certified (FAANS, FACS, FCNS), she starts with the least invasive option that will work, and recommends surgery when it can correct the problem
• Clear answers: known online as Ladyspinedoc, she makes sure you understand your imaging and every option in front of you

What to Expect

Before treatment

Dr. Grunch or one of her physician assistants will review your CT and MRI and explain whether a brace or surgery is the safer path for your fracture.

Procedure day

Stabilization surgery usually takes two to four hours, followed by a hospital stay of several days.

Recovery timeline

• First days: up and walking with help as soon as it’s safe
• Weeks 1-6: brace use if prescribed; no lifting, bending or twisting
• Weeks 6-12: physical therapy and gradual return to activity
• Months 3-12: the fracture heals and strength continues to improve

Frequently Asked Questions

Will I be paralyzed?

Many people with burst fractures have no spinal cord injury. When the cord or nerves are affected, prompt treatment gives the best chance of recovery.

Can a burst fracture heal without surgery?

Yes, many stable burst fractures heal in a brace with close monitoring.

How long will I wear a brace?

Usually about 8 to 12 weeks, depending on how the fracture heals.

Will the screws and rods stay in?

Usually, yes. Hardware is sometimes removed later, which Dr. Grunch will discuss with you.

When can I go back to work?

Desk work often resumes in a few weeks to a few months. Physically demanding jobs may take longer.

Take the First Step Toward Relief

Whether you need a diagnosis, a treatment plan or a second opinion, Dr. Grunch and the Southern Neurosurgery team are here to help.

Call 470-293-9800 to schedule an appointment or contact us online.

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We see patients across metro Atlanta and North Georgia at our offices in Gainesville, Sandy Springs and South Atlanta (Riverdale). Find the office nearest you.

This page is for educational purposes only and is not a substitute for medical advice. If you have sudden weakness, numbness in the groin, or bladder or bowel changes, call 911 or go to the nearest emergency room.