L5 Vertebral Fracture: Treatment Options & Recovery

Treatment of an L5 fracture depends on stability, neurologic status, and patient factors.

Stable Fractures (No Neurologic Deficit, Intact Posterior Ligamentous Complex)

• Conservative: Brief rest (1–2 days), early mobilization, analgesics (NSAIDs, acetaminophen), lumbar orthosis (TLSO or LSO) for 6–12 weeks.
• Physical Therapy: Core strengthening, posture, gait training after pain controlled.
• Bone Health: Calcium, vitamin D, DEXA; consider anti-osteoporotics if indicated.

Unstable Fractures (Neurologic Deficit, PLC Disruption, Significant Kyphosis, Canal Compromise)

• Surgical Stabilization: Posterior pedicle screw fixation ± decompression (laminectomy).
• Anterior/Combined Approach: If severe vertebral body comminution with canal compromise.
• Minimally Invasive: Percutaneous screws, kyphoplasty/vertebroplasty for selected compression fractures.

Goals

• Neurologic preservation/recovery.
• Pain control.
• Spinal alignment/stability.
• Early mobilization to prevent complications (DVT, pneumonia, deconditioning).

Outcome

Most stable fractures heal well with conservative care. Unstable fractures with surgery have good outcomes if no complete cord injury. Long-term: monitor adjacent segment degeneration, chronic pain.