Could My Symptoms Indicate a Potential Spinal Fracture?

Q: Could My Symptoms Indicate a Potential Spinal Fracture?

Hello： Typically, fractures of the vertebral arch caused by acute trauma present with significant pain symptoms. <br>Since you did not experience acute back pain after your motorcycle accident 1.5 months ago, it is unlikely that you have a vertebral arch fracture. <br>Commonly, v

Is there a high possibility that my symptoms indicate a spinal fracture?

Hello Dr.
Lee: I am 19 years old and have ankylosing spondylitis.
Previously, I only experienced pain in my buttocks, and I am currently taking Salazopyrin to stabilize my condition.
However, in the past six months, I have been experiencing pain in the spinal area behind my navel when I lean backward, but I do not feel any pain when bending forward.
For the past six months, the pain has only occurred when leaning backward; bending forward does not cause any pain, and I have been able to exercise normally (such as jogging and playing badminton) without increased pain afterward.
Sitting for long periods does not cause more pain, lifting objects does not hurt, and I have not experienced any pain or numbness in my buttocks or legs.
When I lightly tap the spinal area with the back of my hand, it does not hurt.
Essentially, as long as I do not lean backward, I feel fine.
About 1.5 months before these symptoms started, I had a fall while riding my bike and slipped on some leaves, but I only had a scrape and did not experience any other symptoms at that time.
It was only after 1.5 months that I began to have the symptoms mentioned above.
I would like to ask the doctor: Is it likely that these symptoms are due to a fracture of the spinal arch from that fall? Thank you, doctor.

Zhong, 10~19 year old female. Ask Date: 2022/11/22

Dr. Li Wenhong reply Orthopedics

Hello: Typically, fractures of the vertebral arch caused by acute trauma present with significant pain symptoms.
Since you did not experience acute back pain after your motorcycle accident 1.5 months ago, it is unlikely that you have a vertebral arch fracture.
Commonly, vertebral arch fractures (or dissociations) are associated with chronic back pain, which may result from fatigue fractures due to excessive extension (hyperextension).
If you have a vertebral arch dissociation, you should avoid excessive extension movements (such as backward bending or hyperextension).
Changhua Hospital Orthopedics Dr.
Li Wen-Hong

Reply Date: 2022/11/22

More Info

Based on your description, it seems that you are experiencing specific symptoms related to your spine, particularly in the context of your history with ankylosing spondylitis (AS). Given your age and the nature of your symptoms, it is essential to consider several factors when evaluating the potential for a spinal fracture or other spinal issues.

Firstly, the fact that you have ankylosing spondylitis is significant. AS is a type of inflammatory arthritis that primarily affects the spine and can lead to the fusion of vertebrae over time. This condition can make the spine more susceptible to injury, especially in the context of trauma, such as the fall you described. However, the symptoms you are experiencing—pain only when extending your back and not during flexion or other activities—may not directly indicate a fracture.

The mechanism of injury from your fall is also crucial. You mentioned that you only sustained superficial injuries and did not experience immediate pain or symptoms following the incident. This timeline suggests that if there was a fracture, it might not be a typical acute fracture but rather a stress-related issue or a delayed reaction due to the underlying condition of AS.
In terms of your symptoms, the localized pain when extending your back could indicate several possibilities:
1. Muscle Strain: It is possible that the muscles around your spine are strained, especially if they are compensating for the stiffness associated with AS.

2. Facet Joint Dysfunction: The pain could be related to the facet joints in your spine, which can become irritated or inflamed, particularly with certain movements.

3. Spondylolysis: This is a condition where there is a defect in the pars interarticularis of the vertebra, which can lead to pain during extension. This could be a consideration given your history and symptoms.

To address your concerns about a potential spinal fracture, it would be prudent to undergo imaging studies, such as an X-ray or MRI, to evaluate the integrity of your spine. These imaging techniques can help identify any fractures, stress reactions, or other abnormalities that may not be apparent through physical examination alone.

In summary, while your symptoms warrant further investigation, they do not definitively indicate a spinal fracture. The pain during extension could be due to muscular or joint issues rather than a fracture. However, given your history of AS and the recent fall, it is essential to consult with a healthcare provider who can perform a thorough evaluation and recommend appropriate imaging studies. Early diagnosis and intervention can help manage your symptoms effectively and prevent potential complications related to your condition.

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