A fracture of the thoracic spine is considered one of the rarest skeleton injuries. The specified part of the musculoskeletal system is maximally protected from any type of injury. However, if the fall is unsuccessful or as a result of a direct strong blow, a fracture of 11 or 12 vertebrae can occur.
Reasons for the development of pathology
Fracture of the thoracic spine has no gender differences. It is equally common in men and women. In elderly patients, trauma can occur even with a slight mechanical impact due to the natural aging of tissues. Such negative factors can also provoke the disease:
- Injury resulting from a traffic accident.
- Industrial accident.
- Unsuccessful fall from a height, landing on legs or back.
- Tuberculosis of bones.
- Excessive axial load on the spine.
- A direct stab in the back of considerable strength.
- The fall of a heavy object on the chest.
- Lower bone density.
- Cancer of the spinal cord or metastasis.
- Injury received during childbirth.
- Osteomyelitis.
Some medications can provoke the appearance of a fracture of the thoracic spine. Due to their effect, bone density decreases.
Disease classification
Fractures of the thoracic spine are different. They can be classified as follows:
| Parameter | Types and their characteristics |
| Severity | - Stable. The vertebral column remains intact, and during transportation, the vertebrae do not move.
- Unstable. It is characterized by damage to the spinal cord. Bone fragments may exacerbate neurological symptoms
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| Etiology | - Traumatic.
- Pathological (provoked by painful destruction of bone tissue)
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| The number of damaged vertebrae | |
| Nature of damage | - Rotational vertebral fracture of the thoracic spine. It is rare and is the most difficult option. It is characterized by the destruction of nearby bone structures. Such damage occurs with simultaneous exposure to biasing and tensile forces.
- Distraction. It occurs more often and is characterized by severe neurological symptoms.
- Compression. It appears due to the strong pressing of one vertebra into another
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Treatment of a thoracic spine fracture is carried out only after a thorough examination.
Symptoms of pathology
Symptoms of a thoracic spine fracture are usually sharp. They are clearly felt when trying to change the position of the body, since the displacement of the fragments affects the nerves. Common signs of injury are:
- Weakness in the limbs, their numbness. In difficult cases, paralysis develops.
- Acute severe pain.
- Problems with urination (delay).
- Bouts of suffocation.
- Intestinal paresis.
If the pathology appeared due to trauma, then the signs are as follows: a sharp pain syndrome, neuralgic symptoms, stagnation in the respiratory organs, pneumonia.
Diagnostic Features
Before starting treatment for a fracture of the thoracic spine, the patient needs to undergo a diagnosis. First, the doctor interviews the victim and collects his anamnesis. When diagnosing, only hardware methods are used, since laboratory tests will not yield a result.
The patient is assigned;
- Roentgenography. It is done in two projections. In the picture, you can clearly see the type of fracture, as well as the presence of displacement, fragments.
- CT This study is considered the most informative. It layer by layer shows the condition of not only bones, but also soft tissues. Thanks to this diagnosis, the level of vertebral instability, hemorrhage in the spinal cord, and compression of the nerve roots are determined.
- MRI Thanks to this diagnosis, it is possible to accurately determine the location of the lesion, as well as the need for surgery.
- Electrophysiological diagnosis. It is required if there are fragments.
A fracture of the thoracic spine in children requires emergency care. Prior to the arrival of doctors, the victim should be reassured.
First aid and possible complications
Treatment of a compression fracture of the thoracic spine is also a complex procedure. In case of traumatic damage, which is accompanied by fragments, a person needs first aid and call an ambulance.
First of all, the patient's mobility should be limited so that the vertebrae do not move and do not pinch the spinal cord. The victim is laid on a hard and flat surface: a stretcher or the floor. A person should lie on his back. It is better if the whole body of the victim is placed on the plane. To reduce the likelihood of edema, put ice on the site of the lesion.
In the presence of severe pain, the patient can be given the analgesic "Ketonal". It is better to introduce the drug intramuscularly. Other drugs should not be given to him. If a person has lost consciousness, before the arrival of doctors it is necessary to monitor his breathing and heartbeat. So that the tongue does not sink, it is better to turn the head to one side.
In the absence of appropriate treatment, the consequences of a fracture of the thoracic spine can make a person disabled. However, they appear immediately after injury or in the distant future. With damage to the spinal cord and nerve roots, a person can generally lose the ability to move.
Complications of the fracture are as follows:
- Infection of the damaged area, as a result of which osteomyelitis develops.
- Chronic pain in the future.
- Kyphosis (curvature of the spine).
- Kyphoscoliosis.
- Radiculitis of the chest.
- Osteochondrosis.
- Pulmonary thromboembolism.
- Stenosis of the spinal canal.
- Herniated discs.
- Ligament rupture.
- Impaired functionality of organs adjacent to the injured site.
Due to a fracture in the thoracic region, segmental instability of the vertebrae may appear.
Conservative treatment and physiotherapy
Treatment of a compression fracture of the thoracic spine or shrapnel damage at first is done in a hospital. It provides for the use of medicines, physiotherapeutic procedures.
The choice of methods depends on the severity of the disease. Typically, the patient requires such methods of therapy:
| Method | Characteristic |
| Blockade | It is necessary to eliminate severe pain with displacement of the vertebrae. More often used novocaine and lidocaine. In difficult cases, narcotic analgesics are needed. |
| Medications | - Decongestants: Furosemide. They allow you to remove the swelling that provokes pinching of the nerves.
- Anticoagulants. They help to avoid the appearance of blood clots.
- Antibiotics: Amoxicillin. Required if there is a risk of bacteria entering the wound.
- Amino acids. They participate in the formation of bone tissue.
- Calcium preparations.
- Chondroprotectors: Arthra, Don, Teraflex. They improve the condition of cartilage, but they need to be taken for a long time.
- Multivitamin preparations.
- Immunostimulants
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| Spine traction | - Under the weight of your own body.
- Skeletal. It is necessary for simultaneous fracture and dislocation of the spine. Previously, the patient is given an analgesic injection directly into the vertebra. The course of therapy lasts 3-4 months. With such a fracture of the thoracic spine, a plaster corset is applied for the same period
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| Massage | It is assigned to all victims without exception. There are several types of massage: acupressure (effect on biologically active points responsible for the work of internal organs), classical (involves stroking, shaking and patting different intensities). Also in the therapeutic scheme reflex massage is used. In this case, not the points, but biologically active zones are involved |
| Physiotherapeutic procedures | They are used to quickly repair damaged tissues and return mobility. The following procedures will be useful to the patient: - Phonophoresis. The procedure involves ultrasonic treatment of the damaged area. It improves the effect of drugs, as it accelerates their penetration into the blood. The risk of complications is also reduced.
- Inductothermy. Here a high-frequency magnetic field is applied. The procedure produces an analgesic, anti-inflammatory effect, eliminates muscle spasm.
- Electrical stimulation. Restores blood supply to tissues.
- UHF With this treatment, rapid bone healing occurs, edema disappears, the intensity of the inflammatory process decreases
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At the end of the course of conservative therapy, the patient needs rehabilitation after a fracture of the thoracic spine.
Power Features
In order for the recovery phase to pass quickly and without complications, the victim needs to eat well. His diet contains foods rich in calcium, magnesium, phosphorus, zinc. Vitamins D, B are also required. The menu must include:
- Milk, low-fat fish and meat (contain protein and calcium).
- Sour cream, eggs, fish oil, butter.
- In case of shrapnel or compression fracture of the thoracic spine, rehabilitation involves the rejection of coffee and strong tea, alcohol, carbonated drinks, as they wash out calcium from the body.
Subject to the recommendations of doctors, recovery will take place without complications.
Surgical intervention
It is necessary in the absence of a positive effect of conservative therapy. There are several types of operations assigned to the victim:
- Kyphoplasty. This is a minimally invasive procedure, which requires general anesthesia. It is needed if necessary to restore the geometric proportions of the vertebra. A balloon is introduced into the damaged area, which is gradually filled with liquid. After a cavity forms in it, the device is removed. Further, the void is filled with thick bone cement.
- Vertebroplasty. Intervention requires local anesthesia. A small incision is made above the site of damage, through which a metal conductor is introduced into the damaged site. Through this device, polymethyl methacrylate enters the fracture site. A cementitious substance should be administered on both sides of the vertebra.
- Implantation. It is shown only with significant destruction of the vertebrae. During the operation, an artificial implant is used. It should be high quality and hypoallergenic.
Surgery is an extreme option. It should be carried out in the first few days after the patient is injured, always under sterile conditions.
Rehabilitation
It includes physiotherapeutic procedures and physiotherapy exercises. The recovery period involves the elimination of spasms and pain, strengthening the muscle corset. This requires not only physical exercise, but also breathing exercises.
Exercise therapy for fracture of the thoracic spine is first done in the supine position. Rehabilitation can be divided into several stages:
- Elementary. It lasts 2 weeks. It provides exercises that tone the body and muscles, as well as breathing exercises. They are carried out in a prone position. In this case, the patient needs to use the upper and lower limbs. It is forbidden to take your feet off the bed. Exercises for a fracture of the thoracic spine at this time are as follows: clenching the fingers into a fist, bending the arms at the elbows, circular movements of the limbs in the shoulder joints, alternately moving the arms to the sides. After completion of the complex, you need to restore breathing. Repeat up to 4 times a day, duration is 15 minutes.
- Second. Duration - a month (in uncomplicated cases - 2 weeks). Here the spinal muscles are strengthened, regenerative processes are stimulated. Exercises while lying on your stomach. The complex includes: flexion and extension of the arms extended to the sides, bending of the legs with their straightening at a small height above the bed; raising the shoulders and head; imitation of cycling. Gradually, the load intensity will need to be increased. It is important to remember that in this position it is forbidden to sit for 2 months.
- The final one. There are already added exercises in a standing position on your knees and all fours. The following exercises are assigned to the victim: semi-squats on toes with an emphasis on the crossbar; kicking back in turns; walking on your knees back and forth or in a circle. Thanks to such physical education, the mobility of the spinal column is restored, its flexibility, posture stabilization. Intensive classes are performed up to 3 times a day for 40 minutes. The course lasts 1 month. The next 60-90 days, the load decreases, exercises are performed only once a day. For some patients, the rehabilitation course is extended for a year.
Upon completion of the recovery course, a person needs to do fitness in order to maintain the muscles and the spine in optimal condition. Swimming will be beneficial for the body, since it restores the functionality of the skeleton without unnecessary load.
Fracture prophylaxis
Any disease is better to prevent than to cure. In order not to get a thoracic injury, it is necessary to observe the following preventive measures:
- Eliminate any possibility of falls and injuries.
- Be extremely careful while driving.
- Observe safety measures at work.
- Strengthen your back and chest muscles with exercise. Very useful is a visit to the pool.
- Eat properly, so that a sufficient amount of nutrients enter the body. It is better to remove fatty foods and foods high in preservatives from the diet.
- Stop smoking, alcohol abuse, coffee drinks, as this leads to a decrease in bone density.
- Timely treat any infectious or inflammatory processes that entail the development of degenerative-dystrophic processes in the skeleton.
It is difficult to build a prognosis for a chest fracture. It depends on the severity of the injury, the age of the victim, the timeliness of first aid, as well as the correctness of therapy and rehabilitation. But even after minor damage to the vertebrae, a person will have to limit his mobility for a while. The older the patient, the worse the prognosis. Repeated injury to the thoracic region is even more harmful.
It is difficult to obtain a fracture of the thoracic spine, but it is not easy to treat it. Without timely therapy, a person may experience complications that cannot be eliminated without surgery. The rehabilitation period is also very important. Here it is necessary to strictly comply with all the instructions of specialists.