Eagles quarterback Carson Wentz broke a vertebra, meaning he will likely miss Sunday’s game against the Los Angeles Rams. The team has yet to comment on the injury, which kept Wentz out of practice Wednesday and Thursday, but sources told the Inquirer and Daily News that he is expected to heal with rest. Wentz also missed the end of last season and the beginning of this one after tearing his ACL — a key ligament in the knee.
What are the prospects for an otherwise healthy young person who suffers a vertebral fracture? We asked Harvey E. Smith, an associate professor of orthopedic surgery at the University of Pennsylvania’s Perelman School of Medicine.
Question: Some media reports have described Wentz’s injury as a compression fracture, the most common type of spinal fracture. If that is the case, how does that injury occur?
Answer: It’s a fracture of the vertebral body in which you have a loss of height. There are a number of ways to further classify the type of fracture, but I don’t know the specifics here. Generally speaking, your vertebral bodies are structures that have an outer layer of relatively hard cortical bone. Inside the vertebral bone is a softer, cancellous [spongy] bone. When you have a transmission of force, usually with a flexion [bending] component, and the forces imparted on the vertebral body exceed its ability to withstand that force, then the bone will break. You’ll get a break of the cortical bone or the end plate.
Other types of vertebra fractures athletes can incur include a minor end-plate fracture, herniation of disc material through the end plate, or a stress fracture of a part of the vertebra called the pars interarticularis.
Q: Can a broken vertebra be caused by the overall wear and tear of a football season, or is it typically the result of one impact?
A: A compression fracture is generally not a wear-and-tear type of injury. Usually there is an inciting event, particularly in younger men, assuming there’s no underlying osteoporosis. Compression fractures usually would require some type of an acute injury.
Q: If a person is able to walk with a broken vertebra, does that suggest it is not serious?
A: Not necessarily. It’s kind of hard to speculate. You could still have a serious fracture and be able to walk on it. It depends on the injury and the person’s pain tolerance. It’s probably not catastrophic, but just being able to walk doesn’t mean it’s not severe.
Q: What is the treatment for a broken vertebra in an otherwise healthy young person?
A: It depends on the specifics of the injury. If it is a stable injury, a relatively minor compression fracture, then usually you limit activity, and it will heal on its own with limited long-term consequences. If it’s a minor compression fracture, you pretty much shut it down, which would mean for the rest of the season he is probably done. The vast majority of compression fractures are treated without surgery and heal just fine on their own.
Q: Is a brace typically recommended?
A: It depends on the physician treating the injury. Many physicians will offer a brace for comfort. There’s a little bit of discrepancy in the literature regarding whether braces make a difference in the outcome, but many physicians prescribe braces if for nothing else than comfort.
Q: What kinds of complications could arise?
A: Generally, a compression fracture usually heals just fine. If you have a severe fracture with significant deformity, it can lead to chronic pain.
Q: Would the person be more susceptible to reinjury?
A: Not necessarily. It’s about the specifics of the injury, and about how the fracture happened. If it’s a minor compression fracture that happened due to a high-energy mechanism [forceful impact], then usually that’ll heal just fine [as opposed to a fracture in an older person with osteoporosis]. There’s not necessarily any risk for further injury.
Q: How long is the recovery time?
A: Six to 12 weeks. Shut it down in terms of activity, then you need to recondition and ramp back up.
Q: In 2014, Carolina Panthers quarterback Cam Newton missed just one game after a car accident in which he suffered two transverse process fractures in his vertebrae. What does that term mean?
A: It’s a different bone from the vertebral body. Although painful, it generally does not affect the loading of the spine.