Compression fracture of the spine in a child: symptoms, treatment

In children, the bones are in the process of growth, so they are often exposed to various injuries. One of the most serious is a compression fracture of the spine. In a child, it is rare, but such an injury can have dangerous consequences. Therefore, each parent needs to know how to prevent such injuries, how to recognize that a fracture has occurred, and how to provide first aid. Although in children the bones heal faster than in adults, but treatment after such an injury together with a rehabilitation period usually takes at least two years.

What is a compression fracture?

This is a serious damage to the spine, which is a violation of the integrity of one or more vertebrae due to their compression or sharp compression. Often it is accompanied by swelling of the soft tissues, infringement of the nerves or blood vessels. Vertebrae can not only shrink or flatten, but even crack. This happens when jumping or falling from a height, shock or sudden movement. Most often, a compression fracture of the thoracic spine occurs in children or in the lumbar region. Compression of the vertebrae can lead to damage to the spinal cord and paralysis of the limbs. According to statistics, such injuries rarely occur in children. Indeed, until complete ossification, the spine is quite flexible, and the intervertebral discs are high.

Causes of Injury

A compression fracture of the spine in a child can occur even from a minor blow or fall on the buttocks. This is more common in children whose bones lack calcium. This happens with osteoporosis or osteomyelitis. But any child can be injured. The causes of compression fracture are most often the following:

• falls, it is especially dangerous when landing occurs on the buttocks;
• unsuccessful diving into the water;
• sharp tilt or improperly performed somersault;
• car crashes.

Signs of compression fracture

Sometimes the injury happens in a mild form. In such cases, parents may not understand that the child has a compression fracture of the spine. Symptoms of uncomplicated injury are blurry and resemble bruising. Therefore, it is important for any fall on the back or buttocks, a blow to the spine, immediately consult a doctor. It is necessary to conduct an examination and find out if there is any damage.

It is often possible to determine by the external signs and complaints of the child that he has a compression fracture of the spine. Symptoms will vary, depending on the type and location of the injury.

• With a fracture in the thoracic vertebrae, pain in the shoulder blades is felt. Then it covers the entire chest. In addition, the child experiences breathing problems.
• If the lesions have affected the lumbar vertebrae, abdominal pain and chest muscle tension can be observed. Any movement is given to the child with difficulty.
• Forced position of the head and marked deformation in the neck indicate a fracture of the cervical vertebra. The child experiences severe pain, and the neck muscles are tense.
• More serious symptoms are accompanied by a complicated fracture. Damage to blood vessels and nerves leads to numbness of the limbs, their partial paralysis is possible. There is an urination disorder, muscle weakness and low blood pressure.

The most important sign of any compression fracture is pain. It can be strong at first, and then almost disappear or, on the contrary, will increase.

Types of spinal injuries

By the presence of complications, such injuries are complicated and uncomplicated. The danger of the first type is that the child may not say a little back pain. Without treatment, such an injury has dire consequences. Among the complicated ones, a compression fracture of the thoracic spine is especially dangerous . Its consequence may be a violation of the heart and lungs.

Depending on the degree of deformation of the vertebrae, three types of injury are distinguished.

• A compression fracture of the first degree is characterized by a decrease in the height of the vertebra by 30%. Such an injury is successfully treated and, with timely assistance, the prognosis of therapy is favorable.
• A fracture of the second degree is a compression of the vertebra by half. In most cases, serious complications appear after this.
• Deformation of more than 50% is a very serious injury and is rarely diagnosed in children. Typically, a third degree of fracture is characterized by damage to the spinal cord.

Diagnosis of trauma in children

The back pain itself is not the basis for the diagnosis of compression spinal fracture. In a child, such sensations may appear for other reasons. Therefore, if you suspect damage, you must visit a traumatologist. He will prescribe diagnostic procedures that will help to make the correct diagnosis.

• First of all, an x-ray is taken in two projections. This helps to identify where the damage occurred and what its nature is.
• The condition of the spinal cord and the study of the injured spine is done using CT and myelography.
• If there are signs of nerve root damage, an MRI of the spine is performed. Its price is from 2.5 to 7 thousand rubles, but this method of examination is really informative.
• You can also do densitometry, which will help to identify the presence of osteoporosis in the child.
  

Features of first aid

The main rule that adults who are next to a child during an injury must observe is to prevent vertebrae from shifting and their further deformation. To do this, ensure the immobility of the victim and his speedy delivery to the hospital. Spinal injuries are very serious damage, so it is very important to know how to provide first aid with them.

• With a compression fracture in the lumbar region, you need to lay the child on his stomach, putting something soft under his head.
• When injuring in the chest, it is important that the child lies on his back on a flat, solid surface.
• Fracture of the cervical vertebra is especially dangerous because the slightest careless movement can damage the spinal cord. Therefore, you can not touch, and even more so try to correct the spinal deformities. It is necessary to cover the neck of the child with cotton wool or something soft and bandage it.
• In case of any spinal injuries, the injured person must not sit, walk or even turn.

Compression fracture of the spine in children: treatment

The methods of treatment depend on the type of fracture. Complicated injuries can only be treated with surgical intervention: titanium plates are inserted or cavities in the damaged vertebra are filled with special cement. But such injuries in children are quite rare. Therefore, the most popular technique for the treatment of uncomplicated fractures. In order for the prognosis of therapy to be favorable, timely assistance, long-term comprehensive treatment and compliance with the sequence in the application of various methods are necessary. The most effective for such an injury are exercise therapy, massage, breathing exercises and physiotherapeutic procedures.

He undergoes compression fracture treatment in several stages:

1. The first 3-4 weeks after injury. All this time the child is in the hospital. The treatment consists in a strict bed rest and an extraction of the spine with the help of a Glisson loop or Delbe rings on an inclined bed. The purpose of such therapy is to relieve muscle strain, prevent even more severe deformation of the vertebrae and protect the spinal cord from damage. The first few days, you still need to remove pain.
2. In the second month after the injury, the goal of treatment is to restore the function of muscles and ligaments and prepare the spine for motor loads. After an uncomplicated fracture at this time, the child can already get up for a short time. The victim must lie on a firm, level surface without a pillow.
3. Almost an entire year after the injury, an active restoration of the functions of the spine takes place. At this time, rehabilitation measures are held to restore mobility to muscles and ligaments.
4. After this, for a whole year, you must continue to perform a special complex of exercise therapy and physiotherapy procedures. And only after two years after the injury can we talk about a successful cure.
   

Compression fracture of the spine: rehabilitation

A child is allowed to get up and walk 1-2 months after an injury. It depends on the severity and nature of the damage. The first time in an upright position can only be in a special corset. The doctor prescribes the time to wear the orthosis individually. But most of the days the child spends the first year lying on his back or on his stomach. The victim cannot sit for long. It is usually allowed to sit after a compression fracture of the spine only after 4-8 months. The corset is worn for at least a year, depending on the nature of the damage.

The tasks of rehabilitation after such an injury are to restore the mobility of the spine, the work of the ligaments, strengthen the muscle corset and improve blood circulation. For this, physiotherapy procedures are used in the courses. It is very important that over the next two years the child regularly performs special exercises of physiotherapy exercises.

Physiotherapeutic procedures and exercise therapy

They are prescribed a week after the injury. This can be electrophoresis with euphilin to expand the capillaries, magnetotherapy, improves blood circulation, electromyostimulation. UHF, paraffin baths, water procedures are also prescribed. Very effective massage, which is done after the disappearance of pain and is carried out then several times in the course of the next two years.

But the main method of treating a compression fracture is exercise therapy. Its tasks are to strengthen the muscle corset, improve blood circulation and stimulate the gastrointestinal tract. They begin to perform exercise therapy within 3-5 days after the injury. First, these are breathing exercises, muscle tension, and arm lift. It is forbidden to raise your head and legs in the first month. After the disappearance of pain, it is allowed for a short time to roll over on the stomach. The first 1-2 months of exercise are performed only in the supine position. After that, an individual complex is compiled for training in an upright position.

Possible consequences of injury

Most often, an uncomplicated compression fracture of the spine occurs in a child. Usually, recovery from an injury is successful, and after a couple of years the victim may forget about the damage. In 90% of cases, such fractures pass without consequences. But with untimely assistance or lack of treatment, as well as after a more serious injury, there are often complications:

• curvature of the spine, most often scoliosis and kyphosis;
• after some time, osteochondrosis develops;
• a frequent consequence of a compression fracture is sciatica;
• spinal stenosis is very dangerous, which leads to poor circulation;
• the most severe consequence of an injury can be complete paralysis of the lower extremities.
  

Prevention of compression fractures in children

In fact, it is very difficult to protect the child from falls. But parents need to know that those who suffer from osteoporosis are most prone to fractures with minor injuries. Therefore, it is necessary to regularly examine the skeleton of the child and not allow a deficiency in his diet of calcium and vitamin D. After each fall, especially on the back, it is advisable to undergo an examination. The most informative is MRI of the spine. Its price is quite high, but the examination will help in time to identify damage and avoid complications.

It is important that parents provide the child with proper nutrition and the right level of physical activity. It is necessary to protect him from jumping from a height, lifting weights and sharp inclines. Then the spine of the child will always be strong and healthy.