What Is a Chance Fracture of The Spine?

Category: Spine | Author: Stefano Sinicropi

Spinal Xray

A chance fracture, also sometimes referred to as a seatbelt fracture, is a type of fracture that occurs in the spine. The injury gets its name from G. Q. Chance, who first described it in 1948. This type of spinal fracture occurs when the spine flexes and then extends with too much force. Prior to the addition of the shoulder restraint in vehicles, this type of motion occurred more often during car accidents where the occupant was wearing a lap belt and came to a stop very quickly.

They aren’t as common in car accidents today, but they can still occur as a result of severe trauma or what’s known as flexion-distraction forces on the spine. In today’s blog, we take a closer look at chance fractures of the spine.

Understanding Chance Fractures Of The Spine

Because of the forces involved and the shape of our spine, a chance fracture most commonly occurs at the thoracolumbar junction, which is where the thoracic spine connects with the lumbar portion of the spine. The fracture tends to occur on either the 12th thoracic vertebrae of the first or second lumbar vertebrae, although in children it tends to develop in the lumbar region. Although the spinal ligaments remain intact during a Chance fracture, the fracture is typically highly unstable.

Symptoms of a Chance fracture include:

  • Severe back pain
  • Pain that worsens when you move
  • Swelling
  • Decreased range of motion at the site

Given the moderate to high levels of pain and the type of trauma needed to cause a Chance fracture, this isn’t the type of injury that you’re unaware you’re dealing with. You’ll know right away that something is wrong in your spine, but you may not know that you’re specifically dealing with a Chance fracture. If you are dealing with severe back pain after a car accident or similar style trauma, head to a spine specialist or emergency department right away.

Diagnosis And Treatment Of Chance Fractures

As we mentioned above, you’ll know that something is wrong with your spine, but you won’t know exactly what’s wrong until you head to a healthcare facility. Once you’re at a care facility you’ll talk with the treating physician about your symptoms and the cause of the injury before being sent for imaging tests. An X-ray is typically ordered to assess damage to the vertebrae, although more high-energy trauma may involve an MRI or a CT scan in the emergency room. Your doctor will be able to determine if there is a Chance fracture or a different spine injury, and they’ll also assess if there is any damage to internal organs and other structures.

Although Chance fractures can be unstable, you may be able to avoid surgery if there is no damage to the spinal cord and surrounding ligaments. If this is the case, the care team may position you on a Risser table before administering a cast or brace to help get the spine in a position where a brace can allow it to heal. You’ll typically wear the cast for 8-12 weeks, and assuming everything heals as expected, full healing will take roughly six months.

If surgery is required, rods, screws and other hardware will be inserted to help stabilize the fracture site and ensure healing is on the right trajectory. If surgery is needed, full recovery typically takes a little longer, usually around 8-12 months. During this time, you’ll also attend physical therapy to help strengthen the area and increase your mobility.

For more information about Chance fractures, or for help treating your back pain, reach out to Dr. Sinicropi’s office today at (651) 430-3800.

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