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L1 wedge fracture

AnonymousUserAAnonymousUser Posts: 51,465
edited 06/11/2012 - 8:32 AM in Lower Back Pain
Hi. I am wondering if anyone else has had a lumbar wedge fracture. I fractured L1 in Feb after a fall (I am 27 and do not have ostoeperosis. I am still off work 5 months later. I use a TENS, take a variety of painkillers and am also having craniosacral therapy. My last X-ray showed slight deterioration and I am now awaiting MRI results next week. I wear a brace, though now thankfully only when out of the house. My consultant mentioned possible surgery, injecting bone cement to fill out the fracture, pending MRI results/depending on pain levels.

If anyone has similar experiences I would love to hear how long it was before pain reduced/stopped/you returned to work etc. Thanks.
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Comments

  • I had lumbar wedge fractures at L2 and L3 after a fall from a horse. I'm in my early twenties, so we're probably similar diagnostically speaking.

    1) I would absolutely caution you against any type of vertebroplasty (the bone cement). I was told by several doctors that at my age that would be an absolute mistake because they're not really sure how the cement holds up in the long run since they typically do that procedure on osteoporotic patients who (how do I say this politely??) don't have the lifespan left that you or I do. Definitely get a 2nd opinion if you have a doctor recommending this. It sounds like they may suspect your fracture is unstable, and in that case there may be some type of hardware they could put in to stabilize things which might be a better option since your young.

    2) It's a little unusual that you are still in your brace. I was out of my brace after 10 weeks because they were very concerned about the de-conditioning that occurs with the brace. That may explain why you are still having pain. When you fracture the vertebrae a lot of the spinal muscles (specifically, the multifidus) become inhibited and it usually takes some type of physical therapy and strengthening to get them working again. If you haven't done so already, it would probably be worthwhile to be evaluated by a good spinal physical therapist. You could also ask the doctor who will be going over your MRI with you if there is any fatty infiltration in the paraspinals because that would be a good clue that at least some of your pain is from weakened muscles.

    3) As far as pain, at 12 weeks I no longer had pain from the L2 and L3 compression fractures. I also fractured my sacrum in the fall so I am continuing to have severe chronic pain from that, but the lumbar fractures felt back to normal after 3 months. This is just a guess, but it sounds like something else is going on if you are still in that much pain from a compression fracture and hopefully it'll show on the MRI. I think it is very typical to expect to be completely back to normal and pain free after 3 months.

    Good luck, and let us know if the MRI shows anything. It sounds like you are doing everything right by continuing to pursue more treatment options and imaging since you're still having trouble.
  • Thank you for your reply. I fell, just slipping on ice. At the time I was told I'd be in the brace for 12 weeks. After the initial 12 weeks was still in a lot of pain and a high level of meds so I had a repeat x-ray which showed deterioration/further compounding of the fracture. I had to continue with the brace full time until 7 weeks ago. I then started physio and was allowed to gradually reduce the time I wore the brace. I now do not wear it at all in the house but wear it still when I go out. I was led to believe the pain would be gone by now - it has reduced but still I require pain relief and am unable to go about things as normal.

    My consultant had mentioned reluctance to perform a vertebroplasty on someone young but would review again with MRI results. I have also read that the longer after injury that the procedure is done the less successful it is likely to be so I am very weary to have something done that may not work and has no known long term affects.

    Good luck with your own treatment/recovery.
  • Hello

    It's so good to find someone with the same injury as me!

    Oct 08 I sustained a wedge fracture of L1 when I fell off a fence. I landed onto concrete sat bolt upright. An MRI showed that the fracture was unstable so I had surgery to fit metalwork to stabilize the area. Post op I wore a body brace for three months. After that xrays showed that the fracture has healed so I was able to discontinue wearing the brace.

    I thought I had recovered by Jan 09 as I felt loads better and had returned to work. But 2-3 months ago I started to experience a lot of stiffness and pain in the lower lumbar region. This is probably due to not having physio post op...

    I am now awaiting another op to remove the metalwork which will hopefully increase my flexibility.

    I'm sorry to hear you are still having problems, it does seem unusual that your fracture is taking so long to heal. What is the latest on your situation?
  • I had a compression fracture in L1 in April of this year. I was told that you should not do the cement surgery thing due to my age. I wore a brace for 8 weeks and then was released. I haven't had any pain from about week 10 on although I just had spinal fusion surgery in L5/S1, so I doubt I would notice any pain in L1!
  • It is really good to hear from someone with the same injury! (Not that I would wish it on my worst enemy)

    Seen the consultant again today. MRI shows the fracture is healing. He explained the anterior height is reduced by just over 50% if that means much to you - he showed me the slides and demonstrated how it was measured etc but not sure what an average height reduction is. Anyway, he thankfully feels I don't need surgery at the moment as have improved slowly month by month. He added he would reconsider surgery if I am in pain 2 yrs after my fall and that by then 90% of people with the same injury would be fully recovered. The other 10% do not appear to make marked approvement beyond this time, hence review at that point.

    I have been seeing physio fortnightly, which I am to continue. To see consultant in 3 months unless any probs in meantime. And I am now allowed to drive! This is a huge thing for me, partly as I need to drive in my work but more that I feel more independant again. I've been advised to wear brace whilst driving until feel adjusted to it and otherwise if I want support - I wont be wearing it apart from driving, I can't wait to bin it!

    Am seeing my manager thursday for informal meeting about when I might return to work and provisions for phased return. Work have been very good - I was on duty when I fell...

    Sorry for rambling on. Just had a lot of info today and good to get my head around it all.

    I hope you don't have to wait long for your op. From your post I'm sure you will, but request physio if not offered and make the time to do the exercises. Yes they do hurt a bit and unless you include them in a daily routine they are easy to forget but are worth doing for a fuller and longer recovery. Hopefully this will be the last of all your problems,
  • I am glad you made a good recovery from your recent L1 fracture. I am also sorry to hear you have numerous back problems. I hope your surgery was successful and that your pain reduces. Pain is very difficult to measure or quantify. I am glad I have only one back complaint to contend with. I cannot imagine the level of pain simultaneous problems would cause however I can only express that the pain I am in, and has such an impact on my day to day life could not be easily overlooked!
  • To pumpkin, LumbarLynne, Lala329

    have any of you guys had metalwork to secure your fractures?
  • I'm so excited to be able to chat to someone with the same injury as me! Congratulations on being able to drive again. I know how frustrating it is losing your independance, and how amazing it is to get it back!

    My consultant told me they would not be able to restore the height of my vertebrae. It has just healed in slightly flattened form. I don't know how much height I lost, I don't really feel any different. Do you feel any shorter than before?

    After having the metalwork fitted and removal of my brace in Jan, my consultant advised that physio would not be necessary at that point. I had no reason to question him because I was feeling loads better and thought things would naturally go back to normal.

    Since my new pain started I have had a few physio sessions and it has been noted that there is no curve to my lumbar spine when I bend over. So all of my bending happens much lower down in the l5 region. This extra stress in a small area is what seems to be causing me the pain. Hopefully once my metalwork is gone I can work on increasing the movement in that area.

    I have loads of things I would like to ask you, I'll try not to bomard you all at once! Feel free to ask me anything you like!

    How long have you been having physio? What kind of exercises do you do?

    It's hard to find young people with this style of injury and without other spinal issues. I'm 26 and had no history before this all happened. Make sure you take care starting back to work. A phased re-start sounds like a very good idea.

    Goodluck with that, I look forward to hearing from you again.
  • Hi I know ist a while since you had your accident but was wondering how you are doing? I too fell on ice January 11th 2010 and had similar to you took ages was in pain and now 16 months on am still in pain, had a brace fitted for 3 months then had terrible time trying to get back to 'normal' felt such a failure as my doctor told me most people are back at work and doing normal things by now. Am having MRI scan Sat as specialist thinks may be problem. But its a terrible injury and you feel horrible. hope you are feeling much better Catherine.
  • Hi everyone,

    I know this post is a few years on from when everyone else has posted but I just came across it on google when looking up my injury. I recently suffered from an L1 compression wedge fracture in a car accident in march I am 19. I have been put on bed rest and light activities for 3 months ( which is nearly up) I have a week of this left and I have to say it just feels like i'm not injured at all now like my back used to be. I was told that my fracture was stable but I was 3mm away from hitting my spinal cord and becoming paralysed, that 3mm is for life which was a hard blow considering my life hobby was banger racing and I work in a animal welfare rescue and rehoming centre. I just wondered if anyone went back to their normal hobbies (horse riding etc) after their injury and if it just felt like back to normal after? I know my consultant said I could go bungee jumping after but I think bungee jumping is a bit different to banger racing where I can have up to 4 cars drive me into a concrete wall at 40/50 mph aye? I look forward to hearing people repsonses. I'm so glad I found a forum with other who have suffered similiar injuries. Please feel free to personal message me.

    Kirstin :)
    K.M.Stone
  • I would strongly encourage you to discuss any return to racing with your surgeon. Is it worth the risk of winding paralyzed? For, me the answer would be no, but it is something that you really need to discuss in detail with your doctor.
  • I fell from a height of 15feet in july last week and had L1 mild wedge compression fracture.
    also discs gap btwn L3-L4=12mm and L4-L5=12mm where asgap btwn other discs
    are 13mm. MRI revealed no damage to spine and any other deformities. Xray was taken
    aft one month and found the bone in good condition. I was on brace for 7weeks and for the last
    one week, am freed from it and doing simple exercises to strengthen back muscles but my doc suggested
    me to avoid bending forward for few more days. Am able to walk freely but sitting for long duration causing
    lil inconvenience. Am a seaman. Al I wanted to know is, can I be able to resume bike riding, running and carry
    some heavy objects? What is the normal gap btwn discs as shown in your MRI scans? How far that reduction in gap
    gonna effect me in future? Btw am 29yrs. Thank you in advance for your valuable suggestions and inputs.
  • LizLiz Posts: 7,951
    There is nobody on the forum qualified or permitted to give you the advice you are asking, you will need to ask your doctor about your mri and when you will be cleared to go back to riding your bike etc.

    http://www.spine-health.com/forum/announcements/spine-health-announcements/welcome-spine-health-how-get-started

    Liz, Spine-health Moderator

  • Hi there, I am delighted to find other people that understand what's going on, basically I was in a bus crash two weeks ago in thailand and I broke my scapula, my tail bone and have a 20% compound fracture to my L1. I'm after flying home to Ireland two days ago after spending 2 weeks in a hospital in Phuket. I had a great doc in thailand and he assured me there was no need for surgery but that I would need complete bed rest and Physio for 3 months. After seeing a bone specialist today in Ireland, I was told not to have complete bed rest and that it may be a year before I'm fully recovered... I'm hoping and praying I will recover quickly so I can be healthy and active before I hit 30 in march. Feeling a bit overwhelmed and down and I'm just wondering do people have any tips / experience for a good recovery or is it a case that everyone is different? Thanks in advance , Leanne xxx
  • Hi
    I was thrown from my Horse 5 weeks ago. I went to ER and had a CT scan. I was told that there is a small piece
    of Bone sticking out. I am wearing a Brace for this fracture. I am walking fine but cannot fully lean over.
    How long does this Brace have to be on.? Will be seeing a Neuro in one week.
    I am 63 and am an Athlete. Anyone else have this?
  • bls28bbls28 Posts: 1
    edited 09/30/2015 - 11:42 PM
    I know it's an old thread but thought I would just advise of my situation. I had an accident in 1989 and suffered a compression fracture to L1 when I was 22. I wore a back brace for 6 months (off work for 3 weeks - how stupid!) and attended an osteopath for about 2 years. Gained full movement with no pain after this time. Since had 2 children and my back has not caused me any change to my lifestyle.

    Until....12 months ago when sciatica kicked in big time! So debilitating :( and never known pain like it. I've been seeing a physiotherapist monthly and my doctor since put me on Nortriptyline - one of the positive side effects of this officially known anti-depressant is nerve pain relief. Much improved now but still got back pain and random sciatica. Prognosis at the time of injury was 20% chance of osteoarthritis in later life, but I'm still only 48 so we'll see how that one goes.

    Physiotherapist puts the pain down to the fracture as subconsciously you protect your spine from further injury and the vertebrae have ceased. Motto for me should have been keep as active as possible bending and exercising in all directions.

    Hope we all improve with time x

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  • Kitt2KKitt2 CanadaPosts: 1
    Hello,
    I suffered a compression fracture of my L1 from an industrial accident in my early 20s. It's been 20 years. I was out of my brace partially at 6 weeks, completely at 10 weeks post accident, while undergoing physio. I can't stress enough the importance of proper exercises especially during the first year.   When the brace first came off, the pain was terrible...those muscles have to be rebuilt up.
    As for activities....I enjoy today things like yoga and flywheel rowing machine (proper technique is vital). Bike riding poses no problems, but I rise out of the seat and take the shock of decending curbs and the like in my legs and forearms, not taking the shock on the spine.
    I haven't been tobogganning since that first winter about 5 months after my accident, because the painful shock I got from just one enthusiastic decend was enough warning to abandon the past-time. Horseback riding needs the same caution. Galloping will cause alot of jarring. English saddle, if you're adept, might be a possibility, but listen to your body.
    Lifting anything away from the body at a distance remains a problem. When my son was a baby, getting him in and out of his car seat was a struggle because I had to get right into the back seat with him and couldn't reach and lift from the outside of the car.
    To all you recently injured...have faith, and take your recuperation time seriously, listen to your physiotherapist and do the exercises faithfully.  You can recover fully, but you can never take your body for granted in the same way you may have in the past. There will probably always remain a lingering sensitivity. For instance the calcium build-up on my fracture works like a fulcrum point, making full-curl situps are impossibly painful.  But by and large you can return to a full active lifestyle. Good luck
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