General principles of spinal compression fracture treatment
Treatment of a compression fracture of the spine is a complex task that will require great perseverance from both the patient and the doctor. The struggle with the consequences of this injury can last for months, its results are difficult to predict. However, you should not despair. In order to understand how to cope with the disease, it is worth studying it more closely.
Mechanism of injury
From a physical point of view, a fracture of a vertebra occurs when the load on it begins to exceed its ability to withstand physical impact. This bone most often suffers from:
- car and other accidents (mainly cervical vertebrae are broken);
- falls from a height in a vertical position;
- hits on the head with a heavy object;
- jumping into the water while diving (the neck is most often affected).
Depending on the mechanism of injury, upper cervical vertebrae, lower (80% of neck fractures), as well as lumbar and lower thoracic (upper thoracic vertebrae are rarely affected) can be damaged.
Symptoms of compression fractures
The main symptom of a compression fracture of the vertebral body is pain. The intensity varies from moderate (because of this, victims quite often do not seek help, believing that they have simply choked) to strong, which requires the appointment of powerful analgesics, including narcotics. Particularly severe pain occurs when nerve roots are compressed. In this case, the second possible sign appears - a violation of motor and sensory functions in the corresponding zone of innervation.
Fractures with wedging of a bone fragment into the spinal canal and compression or damage to the spinal cord are also manifested in a similar way. In this case, the extreme degree of severity of neurological disorders is paraparesis - paralysis of the lower limbs, or tetraparesis - paralysis of the whole body (if the neck is affected).
Treatment of compression fracture of the spine
The first rule is to ensure complete rest of the damaged segment. This is done immediately after the injury: in case of fractures in the neck, a cervical collar is applied, in case of injuries to the lower parts, the victim is immobilized (he is tied to a long board). These manipulations are performed at the pre-hospital stage by "ambulance" workers.
Further tactics depend on the degree of compression fracture and the stability of the spinal column at the site of injury. Stable fractures without neurological disorders and with a decrease in the height of the vertebral body by less than 50% (detected by X-ray) are treated by applying an extension corset for 16 weeks. Subsequently, the permanent corset is changed to a removable one with three fixing points.
In the case of partial or complete instability of the fracture site, the presence of neurological disorders and insufficient efficiency, gradual extension of the damaged part is resorted to. For this, rollers or special devices are used - recliners, the height of which is increased every week. After stretching, a corset is also applied, this is mandatory in the case of a compression fracture of the spine.
Surgical intervention is resorted to when conservative treatment is ineffective and in case of serious neurological disorders caused by complete or almost complete destruction of the vertebra. To do this, with the help of metal screws, plates and rods, the vertebrae above and below the damaged one are fixed to the last, making it immobile.
In case of extensive damage to the vertebral body, it is possible to partially or completely remove it and replace the missing parts with an autograft (made from the patient's bones), an allograft (from processed cadaver bone) or even an artificial prosthesis - a cage made of titanium or strong polymers.
Rehabilitation after spinal compression fracture
The victim's return to normal life begins from the first days after the injury. Immediately after applying the corset, you should start performing exercises according to special schemes. Mandatory physical therapy for a compression fracture of the vertebrae (thoracic, lumbar, cervical), otherwise you may lose your ability to work up to the point of complete inability to care for yourself.
The goal of rehabilitation, depending on the stage of treatment, is initially to preserve and improve the tone of the body, normalize the work of the cardiovascular and respiratory systems, and prevent a decrease in endurance and muscle strength. Later, gymnastics for a compression fracture is aimed at improving regenerative processes in the area of damage, strengthening the muscles of the girdle of the upper and lower limbs. Next, the emphasis is on restoring the mobility of the spine with further strengthening of the muscles. And at the final stage, posture and walking functions are restored, while continuing to strengthen the muscles of the arms, legs and trunk.
Exercises are first performed lying on the back, then (after about 2.5 weeks) it is allowed to turn over on the stomach and perform exercises from this position. After a month and a half, classes can be held in two additional positions - on your back and on your knees. Usually, after 6-8 weeks, the patient is allowed to stand up, and then the exercises can be performed while standing.
Consequences of spinal compression fracture in children and adults
Regardless of age, the result of treatment depends on the timeliness and completeness of the provision of medical care, as well as on the thoroughness of the patient's implementation of all recommendations on gymnastics. Of course, reparative processes are more effective in childhood, but unpleasant consequences can occur in young patients:
- post-traumatic degeneration of intervertebral discs (osteochondrosis);
- post-traumatic kyphosis and scoliosis (persistent deformation of the spine in one or another plane);
- Kümmel's disease (necrosis of bone tissue due to inflammation of the vertebral body).
Adults are more prone to osteochondrosis and Kummel's disease, and distortions most often occur in children. With a compression fracture of the lumbar region, a child develops a scoliotic deformity, and with an injury of the thoracic region, kyphosis occurs more often.
Rehabilitation after a compression fracture of the spine is a complex matter, it can take a year or even more. Our website Dobrobut.com provides information about exercises that will help bring a person back to normal life. Persistence in their implementation will reduce the risk of unpleasant consequences of a compression fracture of the spine - in children by preventing the development of further deformations, and in adults - the beginning of degenerative processes in the area of the injury.
Related services:
Orthopedia and traumatology
Call of the emergency brigade
3.4К views
