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So, when does a broken vertebra actually need surgery?

According to Dr Jayesh Bhanushali, Consultant, Spine Surgery, KIMS Hospitals, Thane, the decision depends on several factors rather than the fracture alone.

“Not every spinal fracture requires surgery,” says Dr Bhanushali. Doctors first assess where the fracture has occurred, its pattern, whether the spine has become unstable, how much the vertebra has been displaced, and whether there is any pressure on the spinal cord or nerves.

Surgery is generally considered when the fracture is unstable or when there is significant collapse or deformity of the vertebra, he explains.

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The presence of neurological symptoms is another important consideration. “Symptoms such as weakness, numbness or loss of bladder or bowel control can indicate neurological involvement and may influence the decision to operate,” says Dr Bhanushali.

Surgery may also be required when the spine cannot be safely stabilised through conservative treatment.

On the other hand, stable fractures without nerve involvement can often be treated without surgery. This may involve pain medication, bracing and close medical follow-up, depending on the individual injury.

 

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Why are some patients transported by air ambulance?

“An air ambulance allows a patient with a serious injury to be transported while maintaining spinal precautions and continuous medical monitoring,” says Dr Bhanushali.

This can be particularly important when specialised treatment is not available at the location where the injury occurred. A medically equipped aircraft can provide oxygen, monitoring, pain control and immobilisation during the journey, with trained medical personnel accompanying the patient.

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However, being flown back is not simply a matter of arranging an aircraft. “The timing of transfer is decided only after the patient is stabilised and doctors determine that flying is safe,” Dr Bhanushali says.

How soon can you fly after a spinal fracture?

“It depends on the type of fracture or surgery, spinal stability, neurological status, pain control and the patient’s overall condition,” says Dr Bhanushali.

Immediately after a major spinal injury, commercial air travel is generally avoided unless the treating medical team confirms that the patient is stable enough to travel. For urgent medical transfers, a specialised air ambulance may be considered because it allows the patient to be monitored and spinal precautions to be maintained throughout the journey.

The situation can also be different after surgery. “After surgery, the treating surgeon should decide when travel is safe based on recovery and the risk of complications such as blood clots,” says Dr Bhanushali.

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How long does recovery from a spinal fracture take?

“A stable fracture may improve over around six to 12 weeks, while more complex fractures requiring surgery can take several months,” says Dr Bhanushali.

That does not necessarily mean a patient has to remain in bed for the entire period. In selected patients, walking may begin relatively early once the spine has been stabilised and the surgeon permits mobilisation.

“Early, supervised physiotherapy focuses on safe movement, muscle strength and gradually restoring daily activities,” he explains.

The timeline for returning to normal activities, however, varies from person to person. “Return to unrestricted activity depends on bone healing, neurological recovery and the nature of the surgery,” says Dr Bhanushali.

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