Spinal injuries are very dangerous, since there is a high risk of damage to the spinal cord and various neurological complications. Even if it is a compression fracture. Such an injury is considered not very severe and with timely treatment, its prognosis is favorable. Compression fracture is very common, especially in children and elderly patients. Complications after it are rare, but the danger is that in the absence of severe pain, not all patients go to the doctor.
What is a compression fracture?
The human spine consists of individual vertebrae. This design allows it to be flexible and mobile, but withstand heavy loads. The body of each vertebra is a spongy bone with a dense membrane. Inside it passes the spinal canal. The vertebrae are small, between them there are elastic intervertebral discs. They perform a cushioning function and protect the vertebrae from damage during shaking and jumping. But with a strong shock or fall, the vertebra can be injured. The most common injury is a compression fracture.
Compression is a lot of pressure. Therefore, the so-called injury, in which there is compression of the vertebra in an upright position. It does not break, but is flattened. This happens especially strongly in its front part, so it takes a wedge-shaped shape. But sometimes, with a severe degree of damage, it may crack into small pieces. Usually, with a compression fracture, 1-2 vertebrae are damaged, sometimes more. At the same time, they decrease in size in height.
Causes
Compression fracture can occur for various reasons. Children, athletes, elderly people are subject to such an injury. Most often, damage can be received in such cases:
- sharp blow to the back;
- falling from a height to the back, buttocks or straight legs;
- a blow to the head from above or diving into the water head first;
- high jump;
- non-observance of safety measures when playing sports;
- car accident.
In people with osteoporosis, a compression fracture is possible even with mild shaking, bending, or tilting. Such damage is considered pathological. They often occur in older women. If several vertebrae are damaged and treatment does not pass on time, a decrease in their height leads to the appearance of a hump. The danger of pathological fractures is that they pass almost imperceptibly, since they do not cause severe pain.
The degree of compression fracture of the spine
The symptoms that are usually manifested and the effectiveness of recovery depend on the severity of the damage. Most often, with household injuries, the fracture is not strong. It may not even cause pain. But sometimes after a compression fracture, prolonged treatment and rehabilitation is required. This happens if the blow was so strong that it caused serious damage to the vertebra.
According to these signs, three degrees of injury are distinguished. The prognosis of the patient’s recovery depends on this.
- At the 1st degree of compression fracture, the vertebra can flatten to a third of its height. Such an injury is easily treatable and rarely leads to complications.
- Grade 2 is characterized by the fact that the vertebra is halved. Bone tissue may be damaged and constrict the spinal cord. In this case, neurological complications are possible.
- Grade 3 is considered a very serious injury, as the vertebra is reduced by more than half. In this case, only surgical treatment is possible, in addition, serious complications most often arise.
How is the injury
Compression fracture is a very common injury, it is quite common in children. The effectiveness of recovery depends on how the treatment will be carried out correctly and on time. Often, after this injury, the person’s mobility is not impaired, the pain can also be not very strong. Therefore, everyone should know how the compression fracture of the vertebra is manifested. Usually after such an injury, the following symptoms appear:
- back pain in the area of ​​the damaged vertebra;
- limb mobility, muscle weakness;
- increased pain during a change of position, coughing, sneezing, sitting or standing;
- local swelling and redness;
- spasm of the back muscles;
- pain on palpation of the spine.
If the injury is so severe that damage to the nerve endings occurs, neurological complications may occur. They appear in the form of numbness or tingling in the limbs, nausea, vomiting, headaches. With an injury in the thoracic region, breathing problems, abdominal pain are possible, if the vertebra in the lumbar region is damaged, there is a risk of disruption of the pelvic organs.
Features of a thoracic fracture
This part of the spine is the least mobile, therefore, less frequently exposed to various pathologies. The vertebrae are protected on all sides and rarely move. But a compression fracture of the thoracic region is common, especially in its lower part. It can be after a fall, a jump from a height, a strong blow to the back.
The danger of this type of injury is that damage to the vertebrae in this section is rarely manifested by severe pain. Therefore, many patients do not see a doctor, but wait for the consequences of an injury at home. some victims do not notice at all that they received a compression fracture. The danger of this is that if you continue to load the damaged vertebra, it will gradually collapse, which after some time will lead to serious complications.
Fracture of the lumbar
This is a fairly common injury due to the high mobility of this spine. A compression fracture can occur when falling on the buttocks, after a strong blow to the back or during a sharp turn. This happens with improper weight lifting, playing sports, with a car accident. People with osteoporosis or spinal curvature are most prone to such injuries.
Treatment of a compression fracture of the lumbar spine must be carried out in a medical institution. In this place, complications more often arise with improper therapy and the absence of immobilization after an injury.
Cervical fracture
A compression fracture in this place is rare, usually after a blow to the head from above or jumping into the water. Such an injury is also possible in a car accident. Damage to the vertebrae of the cervical spine is the most dangerous, since here in the spinal canal there are many nerve roots and blood vessels that feed the brain. A serious compression fracture of the vertebra in the cervical region can lead to loss of mobility and sensitivity of the limbs or even the whole body.
Symptoms of this injury are severe severe neck pain, numbness and weakness in the upper limbs, swelling and redness at the site of the damaged vertebra. Headaches may begin, dizziness, nausea will appear.
Complications
With a mild degree of damage and timely treatment, injury is usually cured easily. Neurological complications rarely occur. Only if bone fragments compress the nerves or blood vessels, numbness of the limbs, tingling, muscle weakness is possible. But most often the pain disappears in 1-2 weeks, and recovery occurs after 4-6 months.
But serious consequences of a compression fracture are also possible. This happens especially often with untimely visits to the doctor or with a severe degree of damage. Most often, vertebral instability develops, their frequent displacement. This can lead to lumbalgia or lumbar ischialgia, chest or neck pain. In addition, compression of the spinal roots can cause neurological complications.
A common complication of this injury is osteochondrosis, protrusion or hernia of the intervertebral discs, arthrosis of the intervertebral joints. Curvature of the spine develops, sometimes a hump appears.
Diagnostics
The main sign of injury is a decrease in pain when lying on a flat surface and their intensification when sitting or standing. But even a doctor can not determine by external signs that this is a compression fracture. Be sure to need a hardware examination. Radiography, CT or MRI is usually done. They help to detect the place of damage, the number of injured vertebrae and the severity of the injury.
Radiography is very informative for identifying a compression fracture. It is made in two projections. In the lateral projection, a decrease in the height of the vertebra is clearly visible. MRI or CT is prescribed only to identify complications or to assess the condition of the spinal cord. Myelography is also sometimes performed.
First aid
In order to avoid complications and facilitate recovery, the actions of the victim himself and the people around him immediately after the injury are very important. First of all, you cannot move, walk or sit. Be sure to lie on your back on a flat hard surface. It is advisable not to transport the victim yourself, but to wait for the arrival of an ambulance. After all, the stretcher must be rigid, a soft roller should be placed under the damaged spine.
If the tailbone is damaged or in the absence of a flat hard surface, it is recommended to lie on your stomach. In case of a fracture in the cervical spine, it is necessary to fix it with a Shants collar. If back pain is severe, ice should be applied to the site of injury. Keep a cold compress for 10-15 minutes intermittently.
Treatment features
This damage is treated in the trauma department of the hospital by an orthopedic trauma surgeon. The purpose of therapy is not only to relieve pain that people who do not go to the doctor do. It is necessary to reduce the axial load on the spine to prevent complications, as well as accelerate the restoration of bone tissue of the vertebra. For this, conservative methods are most often used. Surgery after such an injury is required only in complex cases, when the vertebra is reduced by more than half and neurological complications occur.
But usually the treatment of a compression fracture requires the use of conventional conservative therapies.
- Non-steroidal anti-inflammatory drugs are taken to relieve pain and swelling. Usually effective are Nise, Ketanov, Movalis, Diclofenac. If the pain syndrome is very strong, a perinvertebral block is carried out by Novocain.
- To relieve stress from the vertebra, the patient should lie on a hard surface with the bed tilted 30 ° to the legs. A soft roller is placed under the damaged vertebra. It is also necessary to use soft loops through the armpits back with weighting. In case of a fracture of the cervical spine, traction is carried out using the Glisson loop.
- Bed rest is necessary for 1-2 months, depending on the severity of the damage. Then the patient should wear a tight corset or reclinator. It is forbidden to sit, stand for a long time.
- Physiotherapeutic methods are also used. They are prescribed a few days after the injury, when the pain subsides. These are magnetotherapy, laser treatment, UHF, electrophoresis, myostimulation, paraffin or ozocerite applications, balneotherapy.
With 3 degrees of compression fracture, surgical treatment is used. The operation is performed to restore the height of the vertebra. Typically, vertebroplasty or kyphoplasty is done with bone cement. These are minimally invasive surgeries. Open surgery is required only for a complicated fracture, when the spinal cord is affected or the nerve roots are compressed.
Compression fracture: rehabilitation
After discharge from the hospital, the patient's working capacity is usually restored after 5-6 months. For some time, he needs to observe non-strict bed rest, putting on a tight corset when he gets up. You can’t sit and stand for a long time, especially when treating a compression fracture of the lumbar spine. Usually, in uncomplicated injuries, spinal function is fully restored, especially in children and young people. But for this it is necessary to comply with all the recommendations of the doctor. Recovery after a compression fracture can be lengthy, necessarily includes wearing a corset, massage, physiotherapy exercises. Effectively spa treatment.
Exercise therapy is the main rehabilitation method. First, subject to bed rest, breathing exercises are performed. Then they begin to bend their arms and legs. Actually therapeutic exercises are prescribed after the patient begins to walk. But at first they are still performed lying down. It can be lifting the hull, legs, “bicycle”, “scissors”, “boat”. Then the complex includes walking on all fours, swinging arms and legs. Such gymnastics strengthens muscles and corrects posture.
It is also imperative to follow a special diet to ensure the intake of sufficient amounts of magnesium, calcium, zinc and vitamin D3. It is necessary to exclude all drinks that wash calcium - coffee, soda, alcohol. It is important to avoid increased physical exertion, not to lift weights, not to sit for long. But be sure to do special gymnastics twice a day. This regimen must be observed from 6 months to 2 years, depending on the severity of the damage.