Thought It Was a Disc Issue, but My Lumbar Vertebra Was Fractured?

The spine, often called the pillar of our body, is composed of multiple connected bones. What should be done if these bones are fractured?

The spine consists of a total of 33 vertebrae: 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 5 sacral vertebrae, and 4 coccygeal vertebrae. Each vertebra is made up of a cylindrical vertebral body, a vertebral canal through which nerves pass, and processes extending to the sides and back.

A condition called spondylolysis occurs when the pars interarticularis, the bony segment connecting the vertebral bodies, is cracked or broken.

Spondylolysis can be caused by a congenitally weak pars interarticularis, aging, trauma, repetitive lumbar impact, or poor posture. It can also result from stress fractures caused by overload on the pars interarticularis due to repetitive intense sports such as wrestling, gymnastics, diving, and soccer.

In congenital cases, symptoms may be absent and go unnoticed until adolescence, when rapid growth causes the symptoms to appear.

It commonly occurs in the 4th and 5th lumbar vertebrae. Back pain may occur when maintaining the same posture for a long time, bending the back backward, standing for extended periods, walking a lot, or standing up from a seated position. However, most pain is mild, so many people remain unaware of the condition.

If spondylolysis worsens without significant symptoms or degenerative changes occur in the spine due to aging, the upper vertebra may slip forward, progressing to spondylolisthesis.

Spondylolisthesis is a condition where the upper vertebra slips forward over the lower vertebra toward the abdomen, causing back pain and leg numbness. If left untreated, it can lead to hip or lower limb paralysis, so special caution is required.

Nerve compression within the spinal canal causes pain starting from the lower back or hips and radiating to the legs, numbness, tingling, and other sensory abnormalities. Symptoms typically worsen when walking, making prolonged walking difficult. Improvement is often felt when bending the back forward.

Back pain image. [Image source=Clipart Korea]

Jung Dong-moon, director of the Spine Center at Daedong Hospital, explained, “When back pain occurs, most people first suspect a herniated disc, known as a lumbar disc herniation, which is a condition where the disc between vertebrae protrudes. However, spondylolysis, which involves abnormalities in the vertebral structure, is a distinctly different disease.”

He added, “Many people neglect back pain, attributing it to chronic aging-related conditions or believing it will improve with rest after overexertion. However, if the pain persists or interferes with daily life, it is essential to visit a medical institution for diagnosis and treatment.”

For diagnosis, symptom consultation and X-ray imaging are used to check the vertebral structure. Based on medical judgment, CT scans may be performed to assess the degree of vertebral displacement or separation. MRI scans can be additionally conducted to evaluate the condition of discs, nerve compression, ligaments, and muscles.

In mild cases, non-surgical treatments such as medication, physical therapy, and braces are prioritized.

If pain persists despite treatment, if walking for more than 15 minutes is not possible, or if there are sensory abnormalities or paralysis in the ankles or toes, procedures such as nerve blocks or surgery may be considered when pain severely affects daily life.

To prevent lumbar diseases, it is advisable to maintain proper posture in daily life and keep an appropriate body weight to reduce the burden on the lower back.

Regular exercises to strengthen the back muscles, such as walking, are recommended, and stretching before and after physical activities involving significant body movement is essential.

If back pain occurs, rest in bed and if the pain does not subside easily, visit a medical institution to check the condition.

This content was produced with the assistance of AI translation services.