Burst fracture

A burst fracture is a vertebral body fracture involving the posterior wall, often caused by substantial axial loading. Fragments may move backward toward the spinal canal. Severity depends partly on ligament stability, alignment and whether the spinal cord or nerve roots are affected.

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A compression mechanism

A fall from height or an accident can compress and fragment a vertebra. In the thoracolumbar AO classification, A3 and A4 patterns differ partly by the number of involved vertebral endplates. Associated ligament disruption or translation changes the classification and the assessment of mechanical stability.

Manifestations and emergency signs

Acute spinal pain after trauma needs urgent evaluation. Weakness, numbness, urinary retention, saddle numbness or loss of bladder or bowel control requires immediate emergency assistance. The absence of paralysis does not prove stability. Do not stand up simply to test the ability to walk after a suspected major injury.

Diagnosis

CT defines fragments, posterior-wall involvement and alignment. MRI may be needed to investigate ligaments or nervous tissue. Neurological examination and assessment of associated injuries complement the images. A fragility fracture or suspected pathological fracture may require further investigation of bone health or the underlying disease.

Treatment and healing

Selected stable fractures without neurological deficit can be managed without surgery under surveillance; a brace is considered according to the circumstances. Instability, deformity or neurological compression may lead to an operation. Return to loading depends on healing assessments and medical restrictions, rather than pain relief alone.

Role of TAGMED care

A recent or suspected fracture requires evaluation before musculoskeletal treatment. TAGMED must not use manipulation or traction across an unhealed injury. Following medical clearance, gradual support may help mobility, endurance and return to permitted activities while respecting the treating team’s movement and loading limits.

Frequently asked questions

Is this a simple anterior wedge fracture?

No. The posterior wall is also involved.

Do canal fragments always mean paralysis?

No. Neurological function must be assessed separately.

Does every burst fracture require surgery?

No. Selected stable injuries can be managed with close follow-up.

Does a brace allow unrestricted movement?

No. Prescribed loading and movement limits still apply.

When can physical work resume?

After reassessment of healing, stability and the demands of the specific job.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.