Fractures of the lumbar spine: the first signs, causes, symptoms, diagnosis, treatment and recovery

Fractures of the lumbar spine are more common than others. It is this part of the skeleton that experiences the maximum load. Strong compression, trauma or physiological changes in the bone tissue provoke its destruction. In addition to the supporting apparatus itself, the spinal cord and soft tissues can also be damaged. Treatment of pathology should be started immediately to avoid complications and disability.

Reasons for the appearance

A fracture of the lumbar spine can be obtained at work, at home, on the street. Such negative factors can provoke it:

• Accident.
• Falling from a great height with landing on the buttocks or straight legs.
• Gunshot wound to the spine.
• Sports injuries.
• Anemia.
• Malignant tumor in the lumbar region.
• Increased bone fragility due to poor absorption of calcium.
• Tuberculosis of bones.
• Lymphoma or leukemia.
• Decreased bone density due to the use of large amounts of glucocorticosteroids.
• Age-related aging of the spine.
• Long hunger strike and malnutrition.
• Washout of calcium from the body due to thyroid pathologies.
• Sagging of the intervertebral cartilage.

Fractures of the lumbar spine occur due to degenerative changes in the tissues, which develop due to insufficient functioning of the kidneys, problems with the endocrine system.

Injury classification

Fractures of the lumbar spine are different. They are classified according to several parameters (see table below).

A fracture of the spine in the lumbar is a difficult injury that requires inpatient treatment. Moreover, its duration is 3-4 months - a year.

Symptoms of pathology

A fracture of the thoracic and lumbar spine has certain symptoms. In the first case, the injury is characterized by such manifestations:

• Acute severe pain, which eventually spreads to the perineum, legs.
• Loss of consciousness.
• Nausea and vomiting.
• Traumatic shock.
• General disorders of the mobility of the vertebrae.
• Problems with work and bowel movement.
• Muscle weakness in the lower extremities.
• Numbness of the skin.
• Decreased sensation in the legs.
• Paralytic bowel obstruction .
• Partial or complete paralysis of the legs.

In ICD-10, a fracture of the lumbar spine has the code S32.0. If the damage is light compression in nature, then a person is able to move, but he is lame. Problems with the functionality of the genitourinary system also begin.

Pathology diagnostics

Before starting treatment for a compression fracture of the lumbar spine (as well as its other form), the patient must undergo a thorough examination. It provides:

• Collection of medical history and data on the received injury (if the patient is conscious). Also, a specialist should carefully do a physical examination of the damaged area.
• Reflex test and neurological examination of the victim.
• Roentgenography. It will show the general condition of the damaged vertebrae. The study is conducted in several projections.
• MRI or CT. This diagnostic technique is used if necessary. It shows the condition of not only bones, but also of soft tissues, allows you to determine damage to the spinal cord, the presence of hematomas, the placement of fragments.
• Myelography. Here the assessment of the condition of the spinal cord.
• Densitometry - a study of bone density. Most often, the technique is used to diagnose women who have reached the age of 50. It is in this category of patients that osteoporosis is most often observed.

An examination by a neurologist and traumatologist is also necessary. The consequences of a fracture of the lumbar spine can be very severe: impaired mobility, internal organs, paralysis of the legs or even death.

First Aid Injury

Treatment of a compression fracture of the lumbar spine is carried out in a hospital. However, before the doctors arrive, the victim needs help:

1. Lay on a horizontal hard surface (if the person is conscious). At the same time, a roller is placed under the lower back, and a small stiff pillow is placed under the head. It is important that the patient does not move, as displacement of the fragments can occur. If he is unconscious, then changing his position is prohibited.
2. Turn the head to one side and fix it in this position. So you can avoid the retraction of the tongue and blockage of the respiratory tract (including vomit).
3. Constantly monitor breathing, pulse and pressure.
4. Talk constantly with the victim so that he does not fall asleep before the doctors arrive.
5. If possible, a wide splint should be applied to the broken part of the spine.

Before the arrival of doctors, a person is forbidden to give any medicine.

General principles of therapy

Treatment of a fracture of the lumbar spine provides an integrated approach. The victim needs:

1. Medicines Here, painkillers are most often used. Multivitamins are also needed to improve nutrition of bone and cartilage.
2. Surgical intervention (in the presence of large destruction of the lumbar vertebrae).
3. Physiotherapy and physical activity. Any movements in the first weeks should be limited. Lifting weights is prohibited for a long time.
4. The use of a support corset. It will allow you to remove excess load, maintain the spine in the correct position.

Proper therapy will allow the patient to recover faster.

Surgical intervention

It is prescribed for medical reasons. An operation is necessary if:

1. Instability of the vertebrae is observed.
2. There is a significant amount of bone fragments.
3. Conservative therapy does not give a positive result.
4. Overpressure is observed on the soft tissues at the fracture site.
5. Shards damage the spinal cord, impairing its functionality.

There are several types of surgical interventions:

• Kyphoplasty. A special balloon is introduced into the damaged vertebra, with the help of which a certain space is created in it. After removing the device, the void is poured with special bone cement. This allows you to fasten the vertebra, increase its density, restore height.
• Vertebroplasty. A special cementing substance is introduced into the vertebra through a special metal rod.
• Radical implant placement surgery. It is necessary for severe destruction of vertebral structures, as well as for damage to nerves.

Surgery is a last resort. After him, rehabilitation is also needed.

Fracture massage

Massage with a fracture of the vertebra in the lumbar is almost always done. The patient requires such exercises:

• Stroking (relaxes the spinal muscles).
• Kneading (enhances blood circulation in the injured area).

Specialist movements should not cause pain or other discomfort to the victim. The duration of the session is 15 minutes. Their number ranges from 10-15.

The use of exercise therapy

Exercise therapy for a fracture of the lumbar spine is the main method of rehabilitation. It can be combined with breathing exercises. When moving the lower extremities it is forbidden to take them from bed. Raising two legs at the same time is also impossible.

The duration of the training does not exceed 15 minutes. The initial stage of rehabilitation is 15 days. In general, the course may exceed 12 months. At the second stage, the muscle corset is strengthened. Here the spine must be prepared for the intense loads of the final stage. Lastly, power loads are added.

Exercise therapy cannot be done if the patient:

• Basal temperature increased.
• Constantly present pain.
• There are manifestations of neuralgia.
• Asthenic syndrome has developed.

Any exercises are prescribed by a doctor and begin even in a hospital under the supervision of a rehabilitologist.

The use of physiotherapeutic procedures

To improve the result of conservative and surgical treatment, physiotherapeutic procedures are necessary. Useful for the patient will be:

1. Electrophoresis It eliminates pain, so it is carried out with the use of novocaine. The procedure speeds up the entry of other drugs into the damaged area. Conventional methods of treatment cannot provide such an effect.
2. Magnetic therapy. The procedure consists in processing the damaged part of the lower back with a pulsed magnetic field. The duration of one session is 15 minutes. In this case, the pain goes away, and broken vertebrae recover faster.

Any warming procedures need to be agreed with the doctor, since with such injuries they can be contraindicated.

Features of using a corset

A corset for a fracture of the lumbar spine can reduce the load on the damaged area. It is semi-rigid, hard with metal inserts, gypsum. The choice of product is carried out by the doctor depending on the degree of complexity of the injury. There are also some rules for its application:

1. It is forbidden to put the product on a naked body - under it should be a shirt.
2. Before going to bed, it should be removed.
3. The device must be adjusted by a specialist.

The corset will allow a person to begin rehabilitation faster and restore normal spinal mobility.

Possible complications and prevention

According to the ICD, a fracture of the lumbar spine is considered a serious injury, in the absence of treatment of which a person may experience the following complications:

• Intervertebral hernia.
• Paresis and paralysis of the lower extremities.
• Sexual impairment in men and women.
• Urinary incontinence, diseases of the excretory system and genitals.
• Infectious infection.
• Sepsis.
• Stenosis of the spinal canal.
• Chronic vertebral instability.
• Fatal outcome.

To prevent injury, it is better to observe such precautions: avoid falls, be careful while driving or at work, treat inflammatory processes in the skeleton in time. You should also temper the body and consume multivitamin preparations that increase bone density. Exercise to strengthen muscle corset, prevention of degenerative and dystrophic processes.

Fracture of the lumbar spine is a complex injury that requires the exact implementation of the recommendations of doctors. Proper rehabilitation and timely treatment will quickly restore injured areas, and return a person to a full life.