Compression fracture of the lumbar spine: treatment and rehabilitation

Compression fracture of the spine: treatment and rehabilitation

The human spinal column performs many functions, providing amortization, all sorts of movements by the trunk, protection of the spinal cord.

Vertebrae are a spongy bone tissue, so with a simultaneous pronounced axial load and flexion position of the spine, they can undergo compression. In this case, the vertebra acquires a wedge shape with a decrease in the height of the anterior section.

Compression "explosive" fractures are possible when the spongy bone tissue inside the vertebra is destroyed due to the depression of the intervertebral disk of the pulpous nucleus into his body, these fractures are heavier. If the patient suffers from osteoporosis, i.e.

It has decreased bone density, compression of the vertebra can occur at the lowest load. And not always a compression fracture, especially a pathological one, is revealed on time.

Causes

Compression fractures often occur against the background of osteoporosis.

1. Mechanical impact on the spinal column, such as a fall from height to foot, lifting weights, car accidents, less often - a blow to the back.
2. Pathological fractures against the background of osteoporosis, vertebral tumors. Osteoporosis leads to loss of bone mass, bone becomes thin and unable to withstand the load.

   In postmenopausal and senile osteoporosis, as a rule, several vertebrae are compressed, most often the lower thoracic and upper lumbar spine.

Classification

Uncomplicated compression fractures are divided by the degree of compression:

• 1 degree - decrease in the height of the vertebral body less than half;
• 2 degree - its height is reduced by half;
• 3 degree - the height is reduced by more than half.

Complicated fracture is characterized by injury to the spinal canal. The stability of the vertebral segments is disturbed, the vertebrae undergo dislocation or subluxation, as a result bone tissue injures the nerve roots, is pressed into the channel where the spinal cord passes.

Symptoms

• Back pain, usually intense at the time of fracture, is further constant, aching, worse when walking, sitting. It can give in the arm or leg, depending on the localization of the fracture. In addition to pain, the patient often feels the numbness of the limb. If the compression of the vertebra occurs gradually (with osteoporosis), the pain syndrome is mild, slowly increasing.
• Strain of the paravertebral muscles in the form of painful cords along the spine (the so-called "symptom of the reins").
• With multiple fractures, there may be a shock condition: pallor of the skin, sweating. The patient lies with the legs brought to the abdomen.
• If the fracture is complicated, paralysis develops, a fatal outcome is also possible, if the measures are not taken in time.

First aid

If there is a suspicion of a fracture of the vertebrae, it is advisable to leave the victim at the scene of the incident before the arrival of the ambulance team, not to let him sit down, get up.

If transportation is still necessary, it must be careful, on a shield or rigid stretcher, observing the axis of the spinal column. Under the injured spine, a soft cushion should be placed.

If there is a non-rigid stretcher, the patient should be gently placed on the abdomen.

Diagnostics

Radiography of the spine can reveal a compression fracture.

It is very important to quickly diagnose correctly, because qualified medical care for a compression fracture of the spine should be provided immediately.

The doctor conducts a general and neurologic examination of the patient, assessing his condition, including the function of the spinal cord. An x-ray of the interested department of the spine is assigned in two projections.

As an additional method, computer tomography may be indicated. This study will help to study in detail the nature of the fracture.

It can be performed in conjunction with myelography to determine the state of the spinal cord at the level of the fractured vertebra. When a trauma of the nerve structures, a magnetic resonance tomogram is performed. In a planned manner, all females over the age of 50 years, especially if the trauma is low-energy, is conducted osteodensitometry (to determine the density of bone tissue).

Treatment

Tactics depends on the degree of compression: at the first and second - conservative therapy, it is necessary in the conditions of a hospital, at the third - surgical treatment. With complicated fractures, treatment is also prompt.

Methods of conservative treatment

1. First of all, anesthesia. To this end, the doctor prescribes anti-inflammatory drugs, such as movalis, diclofenac, ketoprofen, arkoxy, nise, and others. In the place of fracture, it is better to put the cold for 10-15 minutes, and so 4-5 times every 15 minutes.

   In severe pain syndrome, the traumatologist performs an invertebral injection of 15-20 ml of 0.5% novocaine on each side of the fractured vertebra.

2. The position on the hard board with the inclination of the foot end is 30 degrees, with the roller under the back in place of the fracture.

   This is necessary to unload the vertebra and to remove the axial load, which occurs in the vertical position of the body. Bed rest lasts usually within one to two months after the injury, depending on the localization of the fracture.

   With a trauma to the cervical region, the stretching is carried out with the Glisson's chin loop.

3. Further, fixation with a rigid hyperextension corset (reclinator) is shown.

   It supports the spinal column at the fracture site in the state of slight extension, thus, pressure is eliminated on the anterior section of the fractured vertebra. If a transpedicular fixation is performed, the patient does not need a corset. Do not sit, long vertical position.

4. Already during the period of bed rest and wearing a corset the doctor prescribes physiotherapy (magnetotherapy, laser therapy, electrophoresis, UHF, electromyostimulation) for the purpose of activating blood circulation, relieving pain, enhancing reparative processes.

Operative treatment

If the compression of the vertebra is expressed, it is necessary to restore its normal height. To this end, the following methods are used:

• Vertebroplasty. In the body of the vertebra, special bone cement is introduced, thus restoring its shape.
• Kyphoplasty. The surgeon adjusts the shape and position of the vertebra, fixing with cement.

All interventions are minimally invasive, through small incisions using an endoscope device, at the end of which there is a miniature video camera.

With a complicated fracture, an open surgery is shown. The neurosurgeon performs decompression, i.e.

removes fragments of the vertebrae that press on the spinal cord and nerve roots, then conducts the fixation of the vertebral segment with metal construction to ensure stability.

If necessary, he makes the filling of the body of the vertebrae with bone cement.

Rehabilitation after compression fracture of the spine

Massage and regular exercise therapy will help to recover from the disease.

If the fracture was uncomplicated, and he was treated conservatively, therapeutic exercise should begin in the early time after injury, in the first week the patient should do respiratory gymnastics and movements in the joints of the hands and feet.

The next month after the trauma of the exercise is complicated and aimed at strengthening the muscular corset of the back, the muscles of the limbs. The patient is taught to roll over in bed, he can alternately raise his legs to an angle of 45 degrees and keep them on weight for a while.

In parallel, physiotherapy, limb massage are shown. When the patient begins to walk (1-2 months after the fracture), more complex elements of exercise therapy are connected: exercises in the position of kneeling, dosed walking, starting from 15 minutes.

A back massage is prescribed.

After, -4 months (after the control x-ray of the spine), you can proceed to a short finding in a sitting posture (for 5-10 minutes a few once a day with a gradual increase in duration), using unloading wheels or special cushions, perform body tilts forward, exercises in the water environment. A good effect is provided by sanatorium-and-spa treatment. Estimated periods of incapacity for work with compression fractures range from 4 to 12 months, depending on the severity of labor. Up to 2 years after injury, shock loads (running, jumping), carrying heavy loads are counter-indicative.
After surgical intervention (transpedicular fixation), rehabilitation proceeds somewhat differently. A corset is not required. LFK begins on the 2-3rd day after the intervention, first it is exercises for the limbs, and in 10 days they are aimed at strengthening the muscles of the back (from lying on the stomach, kneeling). A month later the complex of exercise therapy becomes more complicated, the period of incapacity for work after surgical treatment is reduced.

What is dangerous is a compression fracture. Its consequences

• Post-traumatic osteochondrosis with protrusions and hernias.
• Segment instability. The vertebral-motor segment consists of two vertebrae and their joints, a ligamentous apparatus, an intervertebral disc between them. With a decrease in the height of the vertebral body, the function of the segment is disrupted, the vertebrae become more mobile with respect to each other, this leads to a rapid development of degenerative processes.
• Kifoscoliosis (persistent deformation of the spine). This complication develops more often after osteoporotic compression fractures of the thoracic region. The patient complains of constant pain, shortness of breath, dysfunction of the stomach, heart, fatigue.
• The most serious complication of the compression fracture is a spinal cord injury with the development of paralysis, which requires surgical intervention and long recovery.

It is important to know that the development of consequences can not occur immediately or be gradual. Bone fragments narrows the vertebral canal, in which the spinal cord lies.

There is numbness of the hands or feet, muscle weakness, hypotrophy and other unpleasant symptoms. This complication is called spinal stenosis, so you need to quickly recognize the compression fracture of the vertebra and begin treatment.

To which doctor to apply

If you suspect a fracture of the spine, you should immediately call an ambulance or go to a traumatologist.

If the destruction of the vertebrae is associated with osteoporosis, a consultation of a rheumatologist, endocrinologist, in women - a gynecologist or gynecologist-endocrinologist for the selection of a substitute hormonal therapy.

If necessary, surgical treatment is performed by a neurosurgeon. In the process of rehabilitation, a physiotherapist, a masseur, a physiotherapy specialist are involved.

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A source: https://myfamilydoctor.ru/kompressionnyj-perelom-pozvonochnika-lechenie-i-reabilitaciya/

Treatment of compression fracture of the lumbar spine

The vertebral column is composed of more than 30 strong vertebrae. Thanks to this structure, it is capable of withstanding enormous loads.

But in some situations, the integrity of the main supporting axis of the body can be compromised - the skeleton is vulnerable at sharp impacts, and consequence of such trauma often there is a compression fracture of a backbone of a lumbar department.

Also, the strength of bone tissue can decrease in cases of a person's disease.

What other situations can cause this injury, what symptoms accompany it, what severity of the fracture exists, and whether it is treatable? About all this further.

Causes

A compression fracture of one lumbar vertebra or several at once, in addition to the situation with a stroke, can also occur with sudden compression of the spine.

Most often, the most vulnerable and the most vulnerable external load is the lumbar department.

The causes of injury of the vertebrae in it can be:

• injuries during sports (more often professional);
• the presence of diseases that affect the strength of bone tissue in the body (eg, osteoporosis and osteomalacia);
• injury when jumping, falling from a height or into water;
• unexpected bumps in the spine (for example, during an accident or a fight);
• deformation and reduction of cartilage in size (desiccation), caused by existing diseases of the bone system, and provoking fracture;
• malignant tumor formation in the spinal column;
• elderly age;
• individual structure of bone tissue in the body, in which the latter has not too strong structure;
• Individual differences of vertebral discs, in which the latter are prone to fracture and cracking.

Symptoms

The compression fracture of the lumbar spine can be determined by following the following symptoms:

1. In the performance of any motor activity, a person experiences a strong sense of pain, which can be sharp, harsh, or moderate.
2. Numbness of the lower limbs, and sometimes of the trunk, accompanied by strong weakness.
3. Painful sensations appearing in the area of ​​the spinal column, and sometimes spreading all over the back with urination, as well as emptying the intestines.
4. Appearance of lameness of one of the lower limbs.
5. Fainting.
6. Reducing the sensitivity of the lower extremities - often a sign of damage to the nerve endings of the spinal cord.
7. Sudden occurrence of nausea, vomiting, dizziness and severe weakness, which appeared after getting injured.
8. Appearance of abrasions and bruising in the place of localization of trauma.

Degrees of gravity

Depending on how badly the vertebrae are damaged, and also on the changes that the trauma caused by the person provoked, the compression fracture may have several degrees of severity:

1. A trauma of the 1st degree is characterized by changes in the size of the vertebra - it grows less by no more than ¼ of its size in normal form.
2. Trauma of the II degree is characterized by a decrease in the vertebra by 1/3 of its anatomical type.
3. Trauma of the III degree is characterized by a change in the size of the damaged vertebra by half - it becomes twice less than its usual size.

So are not revealed complex fractures, having a secretive character. The cause of latent vertebral fractures is most often the disease of the bone system or the entire musculoskeletal system.

Open forms are characterized by severe pain at the site of injury and other relevant symptoms, so this damage can not go unnoticed.

Diagnostics

When the patient seeks a doctor, the patient listens carefully to the patient's complaints, examines and probes his vertebral column. Also, the functioning of the spinal cord and its nerve processes is checked without fail - to avoid additional complications.

Then the patient is sent to the radiology room, where he should take a picture of the spine in 2 versions: in a straight projection, and also his side view.

In cases when the X-ray image does not show the place of the fracture is good enough and there is no possibility in detail to assess the extent of the injury and its severity, the patient is prescribed to undergo a CT scan.

In cases where specialists suspected damage to the nerve processes and spinal cord, it is necessary to obtain more accurate and complete information using magnetic resonance imaging.

Treatment

Treatment of compression fracture of the lumbar spine is to use the following methods:

• The use of vertebroplasty is a surgical intervention performed under anesthesia, during In the region of the waist of the patient, surgeons inject a small-diameter needle filled with a special liquid. The latter is necessary to strengthen the injured lumbar region;
• application of kyphoplasty - restoration of anatomical dimensions of injured vertebrae during surgical operation, in which a specially designed surgical cement;
• removal of fragments and fragments of vertebrae, which compress the nerve fibers of the spinal cord. If necessary, parts of the broken vertebra are replaced with surgical implants made of metal;
• the victim is assigned to wear a specially designed corset during a compression fracture spine - it reduces the load on the spinal column, and also reliably fixes the injured area loins. It is better, when the corset is made by individual measures;
• the prescription of pain medication - the first few days can be used in the form of injections, and then in the form of tablets.

Rehabilitation

Rehabilitation after receiving a compression fracture of the spine by a man consists in the application of therapeutic gymnastics, and should consist of 3 stages:

1. Should be aimed at the restoration of the full functioning of the internal organs of the victim.
2. Should be aimed at strengthening the muscular skeleton supporting the spinal column.
3. It is directed to the gradual preparation of the patient for vertical loads on the spine.

Do not strain the weakened body and not healed to the extent of the spine, trying to quickly recover completely.

Go to the goal you need to gradually, with all the recovery exercises must be strictly agreed with the doctor.

In addition to exercises, manual therapy, massage and physiotherapy are used.

Effects

In time, an unrecognized compression fracture of the vertebra or a doctor who is not treated by all the recommendations may turn around:

• irreversible neurologic disorders (lameness, paralysis, etc.);
• provoke the growth of the hump in the thoracic spine;
• the instability of the spine in its lumbar part.

Prevention

Preventive measures to prevent vertebral fracture in the lumbar region are simple:

1. In good time, consult a doctor if you have back pain and other symptoms that may indicate a trauma.
2. Be vigilant on the roads.
3. Take care of yourself and watch your safety - do not once again take risks and test yourself, for example, jumping with a parachute.
4. If possible, visit the pool - these exercises help strengthen the musculoskeletal system.

A source: https://PerelomaNet.ru/perelomy/kompressionnyj-poyasnichnogo-otdela.html

Variants of treatment of fractures of the lumbar spine

The spine of a person performs important functions for the life of a person. The most important of these is the defense of the spinal cord and the support of the body.

Each of the departments of the spinal column, if damaged, leads to unpleasant and menacing consequences.

The most common injury is the lumbar and thoracic spine.

The lumbar spine has a structure of the five largest vertebrae in the body. His defense is a powerful muscular corset. This is due to the fact that the loin is experiencing the greatest strain in the human body.

Lumbar vertebrae are mobile, in contrast to the sacral region, and are subject to greater wear and tear. In addition to the injury of the body itself, destruction of structural units, for example, transverse, spinous processes, can occur.

It is also often combined one-time injury of the first vertebra of l1 with t11-12 thoracic vertebrae.

According to the International Classification of Diseases 10 revision (ICD-10), this pathology refers to the class of ICD-10 S32 - fractures of the lumbar sac and pelvic bones.

Dependent on the degree of damage. There can be single fractures of the lumbar vertebra - ICD-10 code S32.0, and multiple, ICD-10 code S32.7.

Sometimes the diagnosis is combined with fractures of the thoracic vertebrae (t11-12).

Also there is a compression fracture associated with compression of the vertebral body and decompression, on the contrary, by stretching.

The main types of treatment

Successful treatment of a compression fracture depends on two factors:

The first is the successful rendering of first aid to the victim.

When a lumbar injury is received and a suspected fracture or bruise is required, it is necessary to restrict the movement of a person.

It must be carefully laid on a hard surface and transported for hospitalization of the patient in a medical institution.

In order not to get a displacement of the vertebrae, chipping sprouts and injuring the spinal cord, it is possible to apply a dressing to the waist zone. During transportation, physicians immobilize the patient's spine, imposing a corset. In severe pain syndrome, analgesics are acceptable.

This will reveal the presence of concomitant pathologies, such as osteoporosis, sciatica.

After this, it is necessary to know the extent of damage to the vertebral body, the presence of trauma to the processes and choose a conservative or surgical method of treatment.

In addition to the main course of therapy, with vertebral fractures, the subsequent rehabilitation has an important effect. To treat it is possible methods LFK, massage, osteopathy.

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In the presence of concomitant pathology, a corset is needed on the damaged back area.

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Rehabilitation and comprehensive treatment can eliminate residual symptoms, restore efficiency and prevent disability.

Treatment of vertebral fractures

Due to various injuries, such as a fall, road traffic accident and other factors, damage to the structural parts of the vertebral body can occur.

Compression fracture of the spine rarely provokes trauma of the transverse or spinous processes.

But in connection with the physiology of the lumbar spine, such fractures happen.

Fracture of the transverse processes is most often associated with excessive physical exertion on the lower back. The cause of this phenomenon is the anatomical features.

After hospitalization, this condition should be treated as soon as possible.

In case of fracture of one process, a plaster cast is allowed. When a fracture of several transverse processes is revealed, which is observed quite often, a long bed rest is required for about one month. The corset is used at the discretion of the attending physician.

Treatment with this regimen means staying in a lying position in a "frog" posture with a tightly bandaged loin.

Symptomatic therapy is used to stop the pain syndrome. An injection for analgesia analgesics is done.

When the symptoms of pain are too strong, then treatment with an analgesic blockade with drugs such as Novocain is permitted.

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When trauma to the transverse processes for early recovery is prescribed treatment by physiotherapy. Gives the positive effect of the use of medicinal ointments and compresses.

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After the abolition of bed rest, a comprehensive rehabilitation is carried out. It includes exercise therapy (LFK), massage.

The technique of exercise therapy is chosen individually and is carried out under the supervision of the instructor.

Treatment of vertebral body injuries

Compression fracture most often occurs in the lumbar and thoracic region. The first and second vertebrae of the lower back are most prone to injury. Also compression occurs in combination of l1 with t11-12 thoracic vertebrae.

This is due to the stresses experienced by these parts of the spinal column (t11-12 thoracic, l1-2 lumbar vertebrae). Compression fracture of t10 and other thoracic vertebrae often occurs in conjunction with the cervical spine.

There are 3 degrees of compression fractures. The first is characterized by a decrease in the height of the injured vertebra from 30 to 50 percent. The second degree is characterized by a decrease in the body of the vertebra in half. The third reduces the height by more than 50 percent.

The last degree is most difficult to treat due to possible complications.

Symptoms after fractures of the lumbar vertebrae depend on the complexity and massiveness of the injuries. The uncomplicated form does not affect the spinal cord, and the symptoms are characterized by the soreness of the affected area.

In the case of a fracture that has occurred in connection with long-term pathological processes in the spine, the clinical picture may not be manifested at all. Such conditions are associated with radiculitis, osteochondrosis, tumors, osteoarthritis.

To prevent such a complication, it is necessary to wear a corset.

Complicated fractures imply possible damage to the spinal cord, intervertebral discs and blood vessels. Neurological symptoms join the pain syndrome.

Often there is a partial paresis of the lower limbs, a violation of urogenital function.

Combined compression fracture of the first and second lumbar injuries with t11-12 thoracic vertebrae can cause paralysis of the upper limbs.

Recommendations

In order to achieve efficacy in treatment, it is necessary to follow the regimen prescribed by the doctor. Almost always you need a bed rest and complete rest.

Loads and exercises can be performed only after the doctor's permission. Uncomplicated compression fracture in most cases can be treated with conservative methods.

Corset and other methods of immobilization are used often enough to limit the spine from the loads.

Symptomatic treatment and rehabilitation are important when a corset is removed or bed rest is canceled. Especially when patients lie for a long time, then to achieve full recovery LFC, massage, osteopathy and other methods of recovery are prescribed.

Treatment of a complicated fracture directly depends on how many vertebrae, processes, spinal cord injuries and nearby tissues are damaged. In addition to conservative therapy, surgical treatment is used in different cases.

There are few traumatic techniques that allow you to treat a compression fracture. This vertebroplasty and kyphoplasty. Both methods involve the strengthening and repair of damaged vertebrae. These techniques by action replace the corset.

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When there is a threat of fragments breaking, there is a bias or there is a complicated compression fracture, then a surgical operation is performed.

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During the operation, compression is eliminated, the vertebral body is restored and the displacement is eliminated.

After surgery, rehabilitation is also recommended.

If necessary, worn corset or plaster bandage.

Recovery after a fracture is always long, requires patience and strength, but only so you can restore the body.

A source: http://drpozvonkov.ru/travmy/fracture/kompressionnyiy-perelom-poyasnichnogo-otdela.html

Symptoms and treatment of compression fracture of the lumbar spine: rehabilitation period and possible consequences of trauma

Trauma of bone structures during compression provokes a dangerous condition - a compression fracture of the spine. In most cases, the lumbar region suffers: this zone is constantly experiencing overload. In case of a fracture, the vertebral body is damaged.

It is important to know that a broken element of a dense structure often moves away and damages the spinal cord. In this case, the consequences of trauma can be very severe, up to paralysis of the lower extremities.

Possible causes

The lumbar zone is mobile, in this department most of the vertical load of the spine is concentrated.

Here is the conditional center of gravity of the human body, it is in this area is constantly the point of concentration of efforts to maintain the correct position of the body.

Breaking the strength of bone structures reduces the ability to perform the usual functions, reduces the possibility of confronting efforts, loads of habitual and increased strength.

Compression fracture occurs in two cases:

• In the spine there is an active destruction, which causes the destruction of the body of bone structures and cartilage. Consequence - even small efforts, a weak load on the bone tissue provokes a decrease in the strength of the vertebrae and fractures;
• The external impact is so great that even a solid vertebral body is unable to maintain integrity.

The main causes of compression fracture:

• falling from a great height to the tailbone or lower limbs;
• falling on the head and back of a heavy object (work-related injuries);
• a strong blow to the spine of water when diving, especially from a great height.

Also, reducing the density of vertebrae provoke the following diseases:

• tuberculosis of the spine with damage to the tissues of the musculoskeletal system, structural changes in the bones;
• oncopathology with metastases in the spine or tumors of the spinal cord;
• osteochondrosis with dystrophic changes in the discs, a decrease in the amortization function of the spinal column;
• osteoporosis. Dangerous pathology, especially in the elderly. Reducing bone density with hormonal failures, increased calcium washing, makes the bones so weak that even an easy bruise or fall becomes critical for the vertebrae and joints.

Compression fracture of the spine code according to the ICD - 10 - S32.

Clinical manifestations

Most often the pain syndrome is brightly expressed, the patient enters the traumatological department of the hospital. The latent form is shown less often, especially at the diseases breaking structure of a body of a vertebra.

It is important to know the main manifestations of the compression fracture:

• after a sharp, strong blow, the back and lumbar region are pierced by acute pain, then transmitted to the legs, pelvic region;
• there is numbness of the hands, back, lower extremities, dizziness, fast growing weakness. Symptoms indicate a rupture or partial damage to sensitive nerve fibers;
• in some cases, regardless of the severity of the injury, the patient develops obstruction intestines, but there are no gases, there is no stool, while abdominal bloating, nausea, and urge to vomiting;
• with a severe form of fracture, a traumatic shock with loss of consciousness, violation of cardiac and respiratory activity is possible. Emergency resuscitation is required by ambulance doctors. Neurological disorders, the rupture of sensitive fibers often provokes paralysis of the legs or the entire body below the waist;
• when compression of vertebrae against a background of slow chronic pathology (osteoporosis, osteochondrosis), discomfort is quite moderate. As the vertebrae deform, discomfort increases. With the latent form after the late treatment for medical help physicians often record chronic multiple fractures and fusion of the vertebrae. The result is the formation of a hump.

Classification

Fracture of the bone structure can affect any of the elements of the lumbar zone, but suffers more than 1 vertebra.

This segment has the maximum load, the first vertebra is more affected by mechanical trauma and against the background of osteoporosis.

It is no accident that doctors call this element a "critical point".

Degree of compression fracture:

• The first.The height of the affected vertebra is reduced by a quarter from the original values.
• The second.The degree of compression of the vertebral segment reaches 1/3.
• The third.Vertical size of the problem vertebra on the background of compression is reduced by more than half.

Forms:

• complicated.Worried not only pain syndrome, but also develop neurological complications. When bone fragments are formed after trauma, the risk of nerve root damage is increased many times with the development of a dangerous syndrome and cerebral disorders;
• uncomplicated.The morbidity of the damaged area is moderate, the spinal cord is not damaged, signs of neurological disorders are absent. The danger of this form is the latent course of pathology, the gradual defeat of vertebral structures, the refusal to visit the vertebrologist, the neglected stages of the disease. Against the background of an uncompressed compression fracture, osteochondrosis and radiculopathy often develop.

Note!In the absence of complications in the form of a spinal cord injury, timely treatment, a complex of therapeutic measures, the prognosis is favorable.

Diagnostics

To determine the degree of compression fracture, assess the condition of the spine appoint:

• X-ray, necessarily, in several projections;
• densitometry with a high risk of osteoporosis. The study is mandatory for women over 50;
• MRI (with symptoms indicating a spinal cord injury);
• CT examination to identify the condition of damaged bone structures.

Effective methods of treatment

The obligatory stage is the restriction of the mobility of the fracture zone with the help of a cast bandage or a corset.

The patient wears the device for four months if the patient is in a horizontal position on a special bed, the period of application of an orthosis or plaster bandage is reduced by one or two month.

Conservative therapy options

Features of therapy:

• Analgesics are used to reduce the pain syndrome. An important point is the prevention of inflammation, infectious complications. For this purpose, the patient receives NSAIDs or antibiotics;
• it is necessary to use vitamin-mineral complexes to strengthen immunity, strengthen nutrition of cartilaginous structures;
• on the recommendation of the doctor use local remedies: painkillers for pain in the back, compounds that improve blood microcirculation, non-steroid names with a complex effect;
• at a pressure on the spinal cord and nerve roots designate spinal traction. The procedure is carried out simultaneously on a special table under local anesthesia or on an orthopedic bed, in which the level of slope can be gradually adjusted.

Surgical intervention

With severe compression of the spinal cord, a pronounced radicular syndrome, a high risk of problems with the work of internal organs, the threat of paralysis is prescribed surgery.

Traditional methods:

• doctors replace the affected segment with an implant;
• physicians perform reconstruction of the spine: use plates and fixatives.

A good effect is provided by minimally invasive methods of surgical treatment:

• vertebroplasty - the strength of the affected vertebra is attached to a special medical cement;
• kyphoplasty - the surgeon restores the height of the affected bone structure with air from the can, after the device is extracted, the cavity is cemented.

Rehabilitation period

During the recovery period, doctors put several tasks:

• strengthen muscles, bones, ligaments after prolonged immobility. Prescribe exercise therapy, massage, physiotherapy;
• to develop joints of the spine: with prolonged wearing of an orthosis or gypsum corset for the spine, the risk of post-traumatic contracture in the tissues of the tendons is increased;
• prevention of blood stasis, cartilage damage, neurological and vascular disorders, and other complications.

Rehabilitation methods:

• fortifying compounds;
• preparations with calcium and vitamin D3;
• physiotherapy;
• physiotherapy;
• massage;
• vitamin therapy;
• medical baths;
• swimming;
• classes on special simulators.

Helpful Tips

On a note:

• to prevent compression fractures in the lumbar zone, it is important to avoid falls, jumping water from a high altitude, meet the requirements of TB in the workplace;
• to prevent osteoporosis, osteochondrosis, radiculopathy, you need to eat right, do not overload the lower back, after 40 years take vitamin D3 and calcium preparations;
• it is important to monitor the hormonal background, especially for women, to take drugs that prevent the washing away of calcium during menopause;
• you need to do daily exercises, do yoga, pilates, go to the pool, make long walks. It is important to monitor the condition of muscle tissue, so that the muscle corset does not weaken, and the spine retains flexibility even after 40-50 years;
• every year in adulthood it is necessary to visit the vertebrologist, to clarify the condition of the bone and cartilaginous structures in time to recognize the onset of degenerative - dystrophic changes.

After traumatizing the spine it is important to undergo a full course of treatment and rehabilitation, to limit the load, to strengthen the muscles, bones and ligaments. It is important to understand the causes of compression fractures of the vertebrae to prevent the recurrence of a dangerous injury.

Compression fracture of the spine is a common trauma. Occurs when the vertebral column is bent and compressed at the same time. How to prevent compression fracture of the vertebrae and how to treat the trauma? The answers will be given by the specialist in the following video:

A source: http://vse-o-spine.com/travmy/kompressionnyj-perelom.html

Treatment and consequences of compression fracture of the spine

In ancient times, it was believed that a spinal injury leads to death, and the first healers thought that patients with this trauma are useless to treat, but the last decades have been marked successes in the treatment of spinal patients, however, and now the problem of vertebral-spinal cord injury continues to be relevant, as the frequency of trauma increases the spine.

Fractures of the spine lead to biomechanical changes in the vertebral-motor segment and in severe cases to compression of the spinal cord.

With problems of biomechanics of the spine, an orthopedic traumatologist is engaged, and changes in the spinal cord are performed by a neurosurgeon. Therefore, the treatment and diagnosis of such patients requires a unified effort by traumatologists and neurosurgeons.

Only with the joint solution of problems in patients, the chance of full recovery is increased.

Most often, compression fracture of the spine occurs in the lumbar and thoracic region. The reason for this is the highest load given to the axis of the body. Fracture can occur after falling from a height, when falling on the buttocks, a strong impact in the lumbar region.

The vertebral column is fixed and stabilized in front by the anterior longitudinal ligament, behind the posterior longitudinal ligament, yellow and between and above the spinous ligaments.

After the compression fracture of the lumbar vertebrae in the pathomorphological picture,

• punctured fractures;
• wedge deformation;
• oslochennye and explosive fractures.

Punctured compression fractures are characterized by damage to the anterior column of vertebral bodies, the posterior structures remain unaffected.

Neurological symptoms with this fracture is absent, the spine remains stable.

The wedge-shaped deformities of the lumbar spine are accompanied by asymmetries of the vertebral bodies, which leads to the development of instability.

One of the reasons for the development of compression fractures is osteoporosis.

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Osteoporosis is characterized by loss of bone mass and strength of vertebral bodies, so it leads to a decrease in its height, the vertebrae experience more stress than they can bear. As a result, the compression fracture of the vertebral body develops.

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Depending on the strength of the impact, osciliated and explosive fractures may occur.

Due to the introduction of intervertebral disc structures in fracture sites, the fusion of such fractures is more difficult than the above.

Also, explosive fractures are dangerous due to a rupture of the posterior stabilizing structures, since spinal cord can be damaged after this.

Clinical picture

A sign of a vertebral fracture is pain in the lumbar region. It has a different character and intensity. It can increase with small movements, which confirms the instability of the spine.

However, the intensity of pain depends not only on the damage to the body of the vertebra, but also on the injury of soft tissues and nearby organs.

The worst predictions are shingles around the abdomen and shooting pains in the limbs.

He palpates the spinous processes of the vertebrae of the lumbar region, and specifies the site of the fracture and the area where the photograph is to be taken. When examined, there is a tension around the vertebral muscles.

This is due to the protection of our body from pathological mobility and prevents the displacement of fragments.

Characteristic for patients with spine injury are neurological manifestations of trauma. They are divided into three groups.

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In the first group of patients there is a complete loss of movement in the limbs, there are no reflexes in the lower limbs.

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In the second group, limb movements persist, but their amplitude and strength in muscles decrease. The third group consists of patients who have painful pain radiating from the lower back to the lower extremities.

These symptoms are associated with a complete or partial spinal cord break. They arise due to compression of the spinal cord with bone fragments or damage to the vessels feeding it.

Diagnosis of lumbar injuries

An important role in the diagnosis of spine fractures in the lumbar region is determined by X-ray examination. After receiving a picture, the doctor becomes more aware of the nature of the fracture and the mechanism for obtaining it.

X-ray is performed in two projections: anteroposterior and lateral. More accurate information can be obtained with the help of a tomogram.

In the anteroposterior projection, three symptoms are most typical for the fracture of the spine: disruption of the integrity of the plate, a decrease in the height of the vertebral body and a decrease in height between adjacent vertebrae.

The best method for determining all the damaged structures of the department and the prognosis of recovery after trauma is MRI.

Treatment

The method of treatment depends on the patient's severity.

If there are violations of the pelvic organs in the form of incontinence or a delay in urine and feces, that, as if to ease their suffering more often the patient himself insists on surgical treatment.

In uncomplicated cases, doctors choose the optimal treatment option suitable for the age and acquired somatic diseases of the patient, which will provide the most effective rehabilitation.

Conservative methods include: functional and method of one-stage or delayed reposition. Each of them has its own absolute and relative contraindications.

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The functional method involves immobilizing the patient in bed and early therapeutic gymnastics. After performing exercise therapy in the dynamics of the patient gets better, but this is not an excuse to get out of bed. In addition to LFK massage is prescribed.

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The functional method of treatment after a lumbar injury involves about 2 months of bed rest.

Reposition methods are indicated for compression fractures of the spine after trauma. Its peculiarity consists in imposing an orthosis in the maximum spreading of the spine.

The method has many contraindications from the cardiovascular and pulmonary system. Gymnastics and exercise therapy is not required. After the application of orthosis, early rehabilitation lasts about a month in the hospital.

A source: http://SustavLife.ru/travma/perelom/kompressionnyj-perelom-pozvonochnika-poyasnichnogo.html