When looking into “broken backs”, there are two issues that determine whether or not the injury is super serious, or just kind of serious. This lies with whether or not the fracture is stable or unstable

How is it possible for an NFL quarterback to play in a game less than two weeks after breaking his back?

On December 9th, the star quarterback for the Carolina Panthers, Cam Newton rolled his truck in a two-vehicle accident. While strapped to a spine board, paramedics took him from the scene. He was later x-rayed and diagnosed with two fractured transverse processes (TVP) in his back.

What on earth does this mean? How on earth is it possible for him to practice, with a potential to take the first snap in the Panthers game against the Cleveland Browns less than two weeks after a significant accident?

Lucky for you, I’m here to provide a bit of insight into what is actually going on.

Lets start with some basic anatomy. The spine envelops and protects our spinal cord (there are, of course, other things that protect our spinal cord. However, for the sake of keeping it simple, bear with me). Our spinal cord is the major nerve connection super highway from our brain to the rest of our body. When we fracture our back or neck, our main concern is ensuring that that connection remains intact.

When looking into “broken backs”, there are two issues that determine whether or not the injury is super serious, or just kind of serious. This lies with whether or not the fracture is stable or unstable:

  • A major fracture would mean fracturing a part of the vertebral body that helps carry weight and distribute the forces of movement. A major spinal fracture comes with an increased possibility of nerve damage.
  • A stable fracture doesn’t cause a major threat to nerve problems. With a stable fracture,the parts of the vertebrae that are fractured aren’t as vital to spinal stability. Therefore, the spine can still carry and distribute your weight pretty well (Although, let’s be serious here, not as well as if there wasn’t a fracture)
  • An unstable fracture involves fracturing a part of the vertebral body that helps carry weight and distribute the forces of movement. This makes it difficult for the spine to carry and distribute weight. Unstable fractures have a chance of progressing and causing further damage (again, further damage= potential to affect our neural super highway).

Now is your chance to use the google machine and find some x-ray images to see what these different types of spinal fractures look like. Look these up. They are pretty gnarly:

Vertebral compression fracture
Burst fracture of the vertebral body
Clay shovlers fracture
Chance fracture
TVP fracture

* there are many more, but this should give you a good idea of what these different type of fractures look like.

Anyways, back to the topic at hand. Mr. Newton fractured two of his TVPs. In anatomy land, TVPs fall off to the side of the back part of a vertebrae; thus making this type of fracture a stable fracture. Having said that, TVP fractures can most certainly cause further serious complications; most notably with the lungs, kidneys, spleen, liver and nearby nerves which may impact ones bladder and bowl function.

The fun fact of the day is that transverse process fractures are actually the second most common fracture of the lumbar spine (low back); most commonly at the L2 and L3 level. When these little guys break, your paraspinal muscles are responsible for tearing them from the vertebral bodies.

So, it is apparent that Mr. Newton’s injury was limited to a simple break with no other bone or organ injury. This is a good thing, and he is sure lucky that this was the case.

Now, looking at his ability to return to play, what it comes down to is his pain tolerance. How tough is he? At the end of the day, he did fracture bones. That kind of thing hurts! There is most definitely the human recipe response to trauma ongoing:  swelling, bruising and limitation to his spinal movements (due to the muscles guarding in attempts to protect the area). But in all reality can he play without the risk of further injury? Yes. SO, this week, Mr. Newton has been undergoing treatment from his team medical staff. As well, he has been pushed in practice to see how he and his body will be able to respond in “game-like” situations.

If it were me, I think I’d probably sit this one out. But with the Panthers a half game behind the NO Saints and two games remaining….they might think otherwise.
What do you think the Panthers should do?

As always, if you have any questions, concerns or comments, please post them below or stop by Satori and we can grab a tea (I’m still holding off the coffee!) and chat about it all.

Also, if you have any specific topics, you’d like me to blog about. Let me know!

Cheers,
Dr. Kristian Frantzen

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