Despite its strength, the musculoskeletal system of a person is often subjected to heavy loads, which can result in injuries. The most severe and serious damage is a fracture of the spine. The treatment of a spinal fracture will directly depend on the severity of the injury and the location. With such damage, neighboring tissues, for example, muscles, spinal cord, ligaments, are often involved in the process. This may already pose more serious problems.
We will try to deal with different types of spinal fractures, first aid and treatment of this injury.
Types of spinal fractures
Fractures of the spine are of various types and degrees. Classification of fractures is done according to some signs. Given the damage mechanism, 3 types of injuries can be distinguished:
- Compression fracture. It occurs as a result of compression of the vertebrae under the action of a traumatic force. Often such damage results in a fall on the back, legs or buttocks.
- Flexion-extension damage, or they are also called flexion-extensor. Such an injury is considered the most severe, it is based on flexion and extension of the spine as a result of an accident or the fall of heavy objects on the back.
- Rotational injuries. Their essence lies in the transcendental movements of the spine around the longitudinal axis. This happens because of a direct hit.
Compression fracture, in turn, is divided into several degrees:
- The 1st degree is characterized by a decrease in the height of the vertebrae by less than 50%.
- 2nd degree - the height is halved.
- At grade 3, the height of the vertebrae decreases by more than 50%.
If only one vertebra is damaged during a spinal fracture, then such an injury is called a single fracture. With multiple injuries, the integrity of several vertebrae is affected.
When considering the location of the injury, the following types of fractures can be distinguished:
- Fracture of the cervical spine.
- Fracture of the thoracic spine.
- Damage to the lumbar vertebrae.
In addition to these types, there are several more:
- Stable fracture. With such damage, the vertebrae do not move, neighboring tissues are not damaged.
- Unstable damage. In this case, the vertebrae are displaced, there may be a fracture.
If we consider the deformation of the vertebrae, then the fracture can be classified as follows:
- Wedge-shaped fracture. The injury has the form of a wedge, facing the apex forward, and the base towards the spinal cord.
- Shrapnel. Such damage can be explosive when fragments of the vertebral body are displaced in different directions, and it also happens as a hanging drop. Such fractures are unstable, most often you have to resort to surgery.
Symptoms of a spinal fracture
In order for the consequences of the fracture to be as serious as possible, it is necessary to diagnose it in time, provide proper first aid and transport the victim to the hospital. Symptoms of a fracture can be many, but the most significant and obvious can be called the following:
- Strong pain in the area of injury. The pain usually becomes stronger when you try to change the position of the body or make a movement with your hand or foot.
- Restriction of movements. Since anatomical integrity is violated as a result of a fracture of the spine, all attempts to make a movement end in pain.
- With a severe fracture, deformation of the department that is damaged can be observed.
Do not move the victim if there is a suspicion of a fracture of the spine. The treatment of spinal fracture and its success largely depends on the first aid provided and the complexity of the injury.
Causes of Fractures
Any fracture arises as a result of the excess of the force of impact over the strength of bone formations. In order for the spinal column to break, the following conditions must be met:
- Great impact power.
- Weak bone system.
Typically, spinal fractures occur due to a fall from a height, as a result of increased sports or professional and domestic activities. There is a high probability of such a fracture as a result of a traffic accident.
There are situations when bone tissue becomes fragile as a result of pathological processes in the body. In this case, even small impacts can lead to such an injury. This can happen in the presence of the following diseases:
- Osteoporosis.
- The presence of tumors.
- Tuberculosis.
- Disorders in the endocrine system.
Whatever the reason, first aid for a fracture of the spine should be provided competently so as not to lead to even more serious consequences.
Fracture diagnosis
The pain that occurs during a fracture is not a specific sign of such an injury, therefore, to make an accurate diagnosis, the following examination is necessary:
- Do a spinal x-ray. In this case, a direct and lateral projection will be needed to detect the exact location of the damage and determine the severity of the injury.
- Computed tomography is usually prescribed after radiography to examine the area of damage in as much detail as possible.
- Myelography will show the condition of the spinal cord after a fracture.
- An examination by a neurologist is necessary to check the sensitivity and functionality of nerve endings and the spinal cord.
- The doctor may prescribe an MRI if there is suspicion of damage to the structures of the spine.
- Densitometry is performed in rare cases to exclude osteoporosis.
After all the tests, the doctor will be able to accurately diagnose, determine the complexity of the fracture, assess its danger and choose the right treatment tactics.
Cervical spine fracture
The cervical spine is the initial link in the spinal column. It contains seven vertebrae. Quite often, as a result of a fall on the head, a fracture of the first vertebra, which is called the atlas, occurs.
The danger of such a fracture is that damage can occur not only to the spinal cord, but also to some parts of the brain. For example, if the medulla oblongata is damaged, then this is fraught with respiratory failure and palpitations.
It is more difficult to detect a fracture of the second cervical vertebra ; the patient usually complains of pain during rotation of the head. Depending on the degree of fracture, such an injury can lead to neurological problems or severe damage to the spinal cord, which is incompatible with life.
Damage to the remaining cervical vertebrae, as a rule, occurs as a result of a sharp bending of the neck. If the injury also affects the ligaments, then there is a danger of damage to the spinal cord.
Fracture of the lumbar spine
The most common types of spinal column injuries are compression fractures of the thoracic and lumbar vertebrae. This most often occurs as a result of falling onto the buttocks or jumping from a great height.
If there is a disease of osteoporosis, then a lumbar spinal fracture can occur as a result of a mild fall. The danger is that at the same time not everyone goes to the doctor, taking back pain for symptoms of age-related changes.
Emergency assistance
If you suspect a fracture of the spine, it is necessary to properly help the victim. In this case, you can’t do without visiting a hospital, so transportation must be carried out correctly.
First aid will be as follows:
- Lay the victim neatly on his back on any hard surface: it can be a door, a shield, plywood or any other improvised material.
- Lock legs and torso.
- If the pain in the cervical spine, then it must be immobilized.
- In case of vertebral fracture in the thoracic or lumbar region, put a soft roller under the site of injury.
- After giving the patient a stationary state, you can give an analgesic to relieve pain.
- Do not transport the patient in a sitting position.
Properly rendered first aid can save the victim's life.
Prohibited for suspected spinal fracture
Such an injury is quite serious, so there are some actions that are categorically contraindicated:
- Do not force the victim to sit or stand on his feet.
- It is forbidden to try to push the vertebrae into place independently.
- It is not recommended to give drugs if the victim loses consciousness or swallowing function is impaired.
- Do not pull on hands or feet or attempt to carry the victim on yourself.
Any of these actions can lead to serious complications, so you should not risk human health if there is a fracture of the spine.
Spine Fracture Treatment
In the presence of such an injury, therapy cannot be dispensed with in a medical institution. Only a competent specialist will be able to prescribe adequate treatment, which will avoid all complications.
Treatment can be carried out in two directions:
- Conservative.
- Surgical
Which group should be resorted to in order to cope with the fracture as efficiently as possible depends on the severity of the injury and its location.
Conservative treatment
Usually, a full course of fracture therapy takes about 3 months, it takes place under the constant supervision of a doctor and regular examination in order to identify the process of fusion of damaged vertebrae.
Fracture therapy includes the following steps:
- Getting rid of pain. Such an injury causes severe pain, so the patient needs to be given painkillers, they will not affect the speed of recovery, and the condition will improve.
- Activity limitation. To accelerate the process of fusion of the vertebrae, it is necessary to limit as much as possible any mobility. You can not perform actions that increase the load on the spine, sit and stand less. Without this rule, the fusion rate will decrease.
- Fixation. After a fracture of the spine, many neurological complications can occur. To avoid them, it is necessary to fix the spinal column in one position. For these purposes, you can use a corset for fracture of the spine.Verteroblasty is a procedure with which you can restore the integrity of the spine. They resort to it in case of compression fracture in many clinics. The bottom line is this: a puncture is made in the skin and a metal rod is inserted into the vertebral body, through it the cavity is filled with a solution to strengthen the structure of the vertebra. This procedure is performed under local anesthesia.
- Kyphoplasty is used to restore the height of the vertebra. The doctor makes cuts on the skin and inserts a balloon into the vertebral body, which is inflated to the desired height to restore the size of the vertebra. Then the cement is found, reliably fixing the position.
Surgery
Unfortunately, it is not always possible to deal with such injuries with conservative methods. If a spinal fracture is diagnosed, surgery may be required if there is a risk of neurological complications.
In the process of surgical intervention, the surgeon makes a resection of those parts of the vertebra that injure the nerve roots and spinal cord, and metal implants are placed in their place.
Complications of the operation
Even considering that modern equipment has great potential, and surgeons have experience in conducting such operations, such an intervention is potentially dangerous, since the spinal cord and nerve endings are located in close proximity.
The following complications may occur as a result of treating a compression fracture:
- Kyphotic deformation. This is the appearance of a hump in the thoracic spine. This complication is often found in elderly patients. The patient is often tormented by pain, problems may occur in the work of the cardiovascular system, gastrointestinal tract or lungs. Fatigue quickly sets in, shortness of breath appears.
- Segmental instability occurs most often if, as a result of a fracture, the height of the vertebra has decreased by more than 30%. With this complication, not only pains appear at rest and during movement, but also degenerative-dystrophic processes in the spine begin.
- Bone fragments resulting from complex fractures can lead to neurological complications. They can appear immediately or after some time. Symptoms of such disorders are pain during movement and at rest, as well as a decrease or complete loss of sensitivity and numbness of the limbs.
The more time has passed from the moment of fracture to the start of treatment, the greater the risk of various complications.
Consequences of fractures
An accurate prognosis is difficult to give if there is a fracture of the spine. The consequences can be quite deplorable. Some victims do not reach the hospital and die from spinal shock, this occurs as a result of damage or rupture of the spinal cord.
If the spinal cord is affected , there is a danger of paralysis. Patients may lose their ability to move independently for a long time or for a lifetime.
If a simple fracture of the spine, the consequences may be in the form of osteochondrosis or intervertebral hernia. To avoid such consequences or minimize them, you need to control your treatment, follow all the recommendations of doctors, especially during rehabilitation.
Rehabilitation after a fracture of the spine
It is not always possible to avoid injuries: accident, accident - and here you have a fracture of the spine. Treatment of a spinal fracture must necessarily end with a rehabilitation period. The purpose of this important stage is the restoration of injured vertebrae and the return of the former mobile lifestyle.
For these purposes, doctors resort to the following methods:
- Physiotherapy.
- Electrical stimulation.
- Massage.
- Cold therapy.
- Physiotherapy.
Only an integrated approach can completely defeat a spinal fracture, rehabilitation will accelerate the healing process, prevent complications and restore mobility.