Spinal fractures are traumatic injuries involving the vertebral column and may occur with or without associated spinal cord or nerve root injury. They result from high-energy trauma such as motor vehicle accidents or falls, as well as low-energy mechanisms in patients with weakened bone structure. The primary neurosurgical concern is preservation of neurological function and restoration of spinal stability.

Clinical presentation varies according to fracture level and severity. Patients may experience localized pain, deformity, or neurological deficits including weakness, sensory loss, or paralysis. Neurological injury significantly impacts prognosis and requires urgent evaluation.

Neurosurgical assessment includes detailed neurological examination and imaging. Computed tomography provides excellent visualization of bony injury, while magnetic resonance imaging assesses ligamentous integrity, spinal cord involvement, and soft tissue injury. Fracture classification guides management decisions.

Stable fractures without neurological compromise may be managed conservatively. Surgical intervention is indicated in unstable fractures, progressive deformity, or neurological deterioration. Surgical goals include neural decompression, spinal stabilization, and alignment restoration.

Modern spinal trauma surgery employs instrumentation and fixation techniques to provide immediate stability and facilitate early mobilization. Postoperative care includes neurological monitoring and rehabilitation planning.

Spinal fractures represent complex neurosurgical emergencies requiring timely diagnosis, precise surgical decision-making, and coordinated postoperative care to optimize neurological and functional outcomes.