Compression fracture is a fairly common pathology, which is characterized by damage to the vertebrae in any part of the spine. At the same time, their bodies are not destroyed, but are compressed, taking a wedge-shaped shape. More often, the pathology appears in children, as well as elderly people. In the first case, the cause is excessive activity, and in the second - dystrophic processes in the tissues of the skeleton.
Reasons for the appearance
A compression fracture of the vertebral body appears due to such reasons:
- Injury due to intense vertical load on the spine. This leads to a jump from high to straight legs, a sharp slope, falling to the ground.
- Injury due to a car accident.
- Weak bone structures that osteoporosis leads to. At the same time, tissues can not withstand intense loads and are damaged by slight movement.
- A compression fracture provokes metastases that have spread to the spine. They destroy bone tissue.
- Problems with metabolic processes, dysplasia, as well as other diseases that make skeletal structures fragile.
- A direct blow to the lumbar region, chest, neck.
- Sports injuries.
- Infectious bone diseases (tuberculosis).
- Osteochondrosis. As a result of this disease, the destruction of skeletal structures, cartilage occurs. Vertebral fusion becomes unstable.
The risk group includes patients older than 60 years, people with a genetic predisposition to fragility of tissues. Children can also be included here, since the norm of life for them is high motor activity.
Symptoms of pathology
Compression fracture is characterized by vivid manifestations. The following symptoms of the disease can be distinguished:
- Sharp pain, which can give off to other parts of the body, and in a state of rest subsides. When coughing and moving, the discomfort intensifies.
- Headache.
- Nausea and vomiting.
- Loss of limb sensitivity.
- Slight swelling at the site of damage.
- Segmental instability of the spine.
- Asthenia, a general weakness that only increases over time.
- Impaired mobility.
- Perhaps redness of the skin, the appearance of hematomas at the site of damage.
- Spinal deformity.
If the injury is open, then the patient may begin to bleed heavily. Compression fracture of the thoracic spine is characterized by difficulty in breathing.
Disease classification
Compression vertebral fracture can be classified according to several parameters:
- According to the degree of development of pathology. Here we can distinguish only three stages: the first (the height of the vertebra decreases by less than 1/3 of the original size); the second (reduction occurs by half); the third (indicator more than 50%). The last degree is a very serious condition in which fragments of bone tissue appear.
- According to the consequences of damage: uncomplicated or complicated fracture. In the first case, the pain is not strong and quickly disappears. If complications are present, then the victim has neurological symptoms.
- At the place of localization: damage to the cervical part, compression fracture of the thoracic spine, lower back injury.
- In terms of damage: isolated, multiple, affecting the spinal cord (or not).
A penetrating or non-penetrating compression fracture can also be distinguished. In the first case, intervertebral discs, locking plates are damaged. With non-penetrating trauma, such lesions are absent.
Diagnostic Features
A compression fracture can be recognized by carefully examining the patient. To do this, contact a traumatologist.
Diagnostics provides for the following procedures:
- Roentgenography. It is carried out in lateral and direct projection. The procedure must be carried out throughout the entire period of treatment and rehabilitation.
- Neurological examination. Thanks to him, you can determine the degree of damage to the nerve roots.
- MRI Here the fabric can be considered in layers. You can not only detect the localization of damage, but also see the condition of the vertebrae in great detail.
- Myelography It is necessary for complicated fractures, if fragments damaged the spinal cord.
- Densitometry. This procedure allows you to detect osteoporosis in the early stages of development.
In addition to visiting a traumatologist, the patient needs to visit an endocrinologist (especially for young people).
First aid
Compression vertebral fracture is a difficult disease that requires increased attention from others. The patient should definitely be given first aid and call the doctors. To begin, the victim should be laid on a hard surface.
If there was a compression fracture of the lumbar spine, then a roller should be placed under this area. If the tailbone is damaged, lay the patient on the stomach. A fracture of the neck requires immediate fixation of this part with the help of a Shants collar.
In case of damage to the thoracic region of the patient, it is also necessary to lay it on the stomach, and adjust the roller for the damaged area. Also, before the arrival of doctors, you need to control the heartbeat, monitor the reaction of the pupils. If there is bleeding, a tight dressing will be required.
If the ambulance does not have the ability to quickly leave, then the person can be delivered to the hospital on his own. But this must be done very carefully. Any patient movements are minimized. You should not sit or get up and try. Otherwise, there is a risk of displacement of bone fragments. You need to take a person to the hospital on an absolutely flat and hard surface.
Traditional and surgical treatment
Compression fracture treatment requires a long time, an integrated approach and patient self-discipline. Conservative therapy involves the use of drugs that relieve pain, inhibiting the development of the inflammatory process. Medications are prescribed in the form of tablets and injections.
NSAIDs (Ketorolac, Nimesulide), chondroprotectors are prescribed for a person. With a compression fracture of the thoracic region or any other part of the spine, its fixation is required, the physical activity of a person is limited. It is important to strictly comply with bed rest. Each month, an X-ray diagnosis of the patient is required.
After 1.5-2 months after the start of therapy, physiotherapeutic procedures are included in the scheme: UHF, heating with ultraviolet rays, electrophoresis. Orthopedic devices are used to fix the damaged department. In severe cases, treatment involves surgery. There are such types of interventions:
- Kyphoplasty. Special chambers are introduced into the vertebral body, which are then filled with a special fixing substance.
- Vertebroplasty. To eliminate the problem, a special substance is cemented into the vertebral body. In this case, the bone structure is strengthened. This operation is minimally invasive, therefore, it allows you to quickly achieve the desired effect and reduce the recovery time.
- Resection of structures followed by implant placement. Such an operation is necessary if the patient has spinal instability with a risk of damage to blood vessels, nerve roots, and spinal cord.
Any operation can give neurological complications, leading to subsequent deformation of the spinal column. Therefore, it should be carried out by a highly qualified specialist.
Features of childhood injuries
Compression fracture of the spine in children is often localized in the middle of the thoracic region. It is difficult to diagnose the disease on the first day of injury, since not all children immediately talk about the problem. They may damage several adjacent vertebrae at the same time.
Treatment of a compression fracture in children is carried out with the help of simultaneous restoration of the position of bone structures, followed by fixation of the damaged section with a plaster corset. Spinal traction can also be prescribed, which helps prevent skeleton deformation.
After a while, the child is prescribed physiotherapy exercises, which helps to strengthen the muscles, restore the previous mobility of the body. Also, the victim is prescribed the optimal regime of the day, good nutrition. Subject to the recommendations of doctors, rehabilitation will be faster.
Physiotherapy
The treatment of a compression fracture of the spine is performed not only with the help of drugs and surgical methods. Physiotherapy exercises help accelerate tissue repair, improve mobility, and prevent the development of complications.
Such exercises will be useful:
| Body position | Type of exercise |
| Lying on his back | - Alternating bending of the feet.
- Soft synchronous raising and lowering of hands.
- Flexion of the upper limbs at the elbows at an angle of 90 degrees.
- Exercise scissors.
- Flexion of the lower extremities in the knees, followed by raising the feet.
|
| Lying on his stomach | - Gradual approach of the blades to each other.
- Lean on the palms and forearms, raise and lower the head.
- The lower back deflection, the toes of the feet are extended, and the hands are located at the seams.
|
First you need to start with a few simple exercises. The load increases gradually with the permission of the doctor. After such a fracture, sports are not prohibited. But do not run, ride a bike. It is better to give preference to swimming.
Improving the effect of exercise will allow breathing exercises. As you recover, the development area expands. The maximum duration of the complex is 45 minutes, but the time must be increased gradually.
Fracture recovery
The average recovery period after a compression fracture is 6 months. The rehabilitation period begins almost immediately after the necessary conservative and surgical procedures. In the first 10 days, all patient recovery techniques do not include changes in his body or mobility. Depending on the severity of the injury, active activity may be added from the 2nd to 5th week.
The rehabilitation process involves the use of such methods:
- Physiotherapeutic procedures. They contribute to the restoration of microcirculation in the affected tissues, the regeneration of the vertebrae. Electrophoresis, UHF, sonication of affected areas, ultraviolet heating, cryotherapy, electrical stimulation, paraffin therapy will be useful.
- Physiotherapy exercises. Exercises are aimed at restoring the patient's mobility, strengthening muscle tissue. Additionally improves the functionality of the cardiovascular system, lungs.
- Massage.
If a person needed surgical intervention, then he will need postoperative rehabilitation. It is carried out strictly under the supervision of a doctor and begins on the second day after the procedure.
During the rehabilitation period, it is important to follow a diet that helps restore skeletal tissue. The menu should include foods rich in calcium, phosphorus, vitamins B and C.
You can sit after such an injury no earlier than a month later. It all depends on how quickly the body recovers. Moreover, after completion of rehabilitation, a person will have to use orthopedic devices for some time. Working in a static position, bending heavily or lifting heavy objects is prohibited.
Possible complications and prevention of fracture
Compression fracture of the thoracic vertebra or damage to other parts of the skeleton is fraught with serious complications:
- Stenosis of the spinal canal.
- Disorders of the functionality of the nervous system.
- Spinal deformity.
- Osteochondrosis.
- Radiculitis.
- Paresis and paralysis of the limbs.
- Compression myelopathy requiring surgical intervention.
To avoid such a problem, it is necessary to observe the following preventive measures:
- You should play sports to strengthen your muscle corset. It is better to give preference to swimming in the pool, dancing or fitness.
- Try not to lift heavy things.
- Eat foods rich in minerals and vitamins involved in the construction of the skeleton.
- Refuse bad habits, eliminate fatty and smoked foods.
- Avoid injury to the spine, high jumps, falls.
- Take frequent walks in the fresh air to improve blood circulation in the body.
- During heavy physical work, use orthopedic devices to reduce the load on the spine.
Compression fracture is a difficult pathology. Despite the fact that it does not always lead to damage to the spinal cord and disability, such an injury requires treatment and rehabilitation. Otherwise, it is possible to develop complications that will make a person motionless.