Compression fracture of the spine symptoms and treatment

Compression fracture of the spine

Compression fracture of the spine- violation of the integrity of one or more vertebrae, accompanied by squeezing and decreasing the height. It is a fairly common trauma, often occurs in children and the elderly.

The cause of damage is a sharp bending or forced load, directed along the axis of the spine. There is often a combination of flexion and impact. Fracture is manifested by pain and restriction of movements in the damaged spine.

Pain decreases in the prone position and increases in standing and sitting position. To confirm the diagnosis, a radiograph of the spine is performed, if necessary, CT and MRI are additionally assigned.

Treatment conservative: protective regime, physiotherapy, exercise therapy, wearing corsets and reklinators. Surgical interventions are very rarely required. The outlook is usually favorable.

Compression fracture of the spine is a common injury in which the vertebra is squeezed. A fracture of one or more vertebrae is possible.

Trauma occurs due to intense axial and / or sharp flexion of the spine, sometimes in combination with twisting.

With pathological changes in the vertebrae (osteoporosis, tumors), the cause of the fracture may be a minor injury, for example, flexion of the trunk. Treatment of compression fractures of the spine is done by traumatologists.

In the space between the back surface of the body and the front surface of the arc is the spinal cord. Normally, the body of the vertebra has a cylindrical shape, the height of its anterior and posterior parts is approximately the same.

With a compression fracture, the anterior parts of the vertebra are squeezed, and it assumes a wedge shape.

Damage can occur in any part of the spine, but most often the transitional department suffers (lower thoracic and upper lumbar vertebrae).

Causes of compression fracture of the spine

Usually, the cause of this spinal injury is a fall or jump from a height to the straightened legs or fall to the buttocks. Less common compression fractures occur during road accidents, natural and industrial accidents.

At usual falls, as a rule, isolated damage of one or several vertebrae is observed.

With high-energy injury, it is possible to combine with fractures of other bones, TBI, blunt abdominal trauma, damage to the thorax and urogenital organs.

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With a decrease in the strength of bone tissue due to various pathological processes, compression fractures of the spine can occur with minimal traumatic effects, for example, a sharp slope forward.

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Such fractures are called pathological. The most common cause of pathological fractures is osteoporosis. Similar injuries are common in older women.

With multiple fractures, a significant decrease in the height of the anterior sections of the spine with the formation of senile kyphosis and the formation of a hump is possible.

Second place in the prevalence of pathological fractures of the spine is occupied by compression fractures in primary tumors and metastatic bone damage.

In view of the level of damage, fractures of the lumbar, thoracic, cervical, sacral and coccygeal spine are isolated. Most often, fractures of the lower thoracic region occur, and fractures of the lumbar and upper thoracic parts are less common.

Compression injuries in the cervical region are quite rare.

The sacral department consists of five vertebrae, fused into a single firm bone, an isolated compression of this department by axis with the application of sufficient force is almost impossible, so the usual compression fractures in this area do not occur.

Given the change in height of the vertebra, there are 3 degrees of fracture:

• 1 degree - a decrease in the height of the vertebra less than a third.
• 2 degree - a decrease in the height of the vertebra by less than half.
• 3 degree - decrease in the height of the vertebra by more than half.

Symptoms of compression fracture of the spine

Traumatic damage to unchanged vertebrae is accompanied by sharp pain. With fractures in the lumbar and thoracic areas, there are often difficulties in breathing at the time of injury.

Subsequently, the patient complains of pain in the projection of the damaged vertebra, sometimes radiating into the abdomen. The pains decrease in the prone position, intensify with coughing, deep breathing, movements, as well as standing, sitting and walking.

In some cases (usually with severe or multiple fractures), headache, numbness of the limbs, nausea and vomiting may occur.

A characteristic feature of a vertebral fracture is an increase in pain with pressure on the patient's head, however, the presence of this symptom is not recommended, since pressure along the axis of the fractured vertebra may aggravate traumatic changes.

Pathological fractures are not accompanied by a sharp pain and can occur almost imperceptibly for the patient.

The reason for seeking a doctor for such injuries is usually a gradual increase in the pain syndrome over time, or numbness of the hands or feet, caused by compression of the nerve roots.

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Edema of the damaged department at the time of treatment is usually absent, there are moderate pain during palpation of the damaged department.

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Some patients, especially elderly women suffering from osteoporosis, show a hump or excess stoop caused by previous multiple compression fractures.

Neurological disorders with compression fractures are rare. In some cases, bone fragments can shift posteriorly, squeezing the spinal cord or nerve roots.

Neurological symptoms can appear both immediately and after a short time after an injury. Along with the direct impact on nerve structures, fragments can squeeze the vessels located next to the nerves.

With a decrease in the height of the vertebra by more than a third (2-3 degrees of compression) segmental instability can develop - excessive mobility, "spillage" of the damaged segment of the spine.

With instability in the lumbar region, lumbar pain (low back pain) or lumboschialgia (pain in the foot and lower back) occurs. Pain is reduced at rest, intensified by movement and exercise.

If segmental instability of the lumbar region is combined with posttraumatic narrowing of the spinal canal, compression of the spinal roots is possible.

With instability in the thoracic region, there are pains in the interblade area, with instability in the cervical region - cervicalgia (neck pain), which sometimes joins pain in the shoulder and headache.

Another negative consequence of segmental instability is acceleration degenerative-dystrophic processes, the development of osteochondrosis, arthrosis of the intervertebral joints, protrusions disks and intervertebral hernias.

In the late period, especially after multiple fractures and fractures of 2-3 degrees, kyphosis can be strengthened, and in severe cases - the formation of a pointed or gently sloping hump. This pathology is more common in elderly women suffering from osteoporosis.

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Kifotic deformation of the spine can cause debilitating pain, and also cause a decrease in the volume of the chest and changes in the position of the abdominal organs. As a result, dyspnea, increased fatigue and digestive disorders occur.

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Diagnosis of compression fracture of the spine

The diagnosis is established on the basis of a characteristic history, symptoms and results of radiography of the spine. The images are taken in two projections, the lateral projection is the most informative.

The radiograph shows a decrease in height and a wedge deformation of one or more vertebrae.

If necessary, to assess the condition of the spinal cord and its membranes, as well as ligaments and cartilages of the spine, appoint an MRI or CT of the spine.

If a pathological fracture due to a tumor or metastasis is suspected, an MRI or radionuclide study is necessary.

When suspected of osteoporosis, densitometry and electrophoresis of serum proteins are prescribed.

Young patients with osteoporosis are advised by an endocrinologist to exclude hyperparathyroidism.

First aid for compression fractures of the spine

The patient must be placed on a hard, level surface in the position on the back and urgently delivered to a medical facility. For fractures of the thoracic and lumbar region, a roller is placed under the damaged area.

In cases of fractures of the cervical region, the neck is fixed with a bag of sand or a collar of Shantz. If the patient's tailbone fractures, the patient is placed not on his back, but on his stomach.

If there are no rigid stretchers, patients with compression fractures of the thoracic and lumbar region are also placed on the abdomen, placing a soft cushion under the breast or a small pillow.

Treatment of compression fractures of the spine

The patient is hospitalized in the traumatology department, laid on the bed with a shield, prescribed analgesics and a special complex of exercise therapy to strengthen the muscular corset.

After 6 weeks, the patient is referred for massage and physiotherapy (UHF, UFO, electrophoresis with calcium). At least 2 months, it is recommended to wear a special fixing corset.

Workability is usually restored 6 months after the injury.

In severe cases, operations are performed on the spine. When the spinal cord and spinal cord injuries are damaged, operations are performed through open access.

In the absence of such damage, low-traumatic interventions - kyphoplasty and vertebroplasty - can be performed. When vertebroplasty in the damaged vertebra through a small incision, cement is introduced, strengthening the bone and not allowing it to collapse.

In kyphoplasty, the shape of the vertebra is preliminarily corrected by applying special inflatable chambers, and then filling these chambers with cement.

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Unstable segments are fixed using various metal structures: screws, plates, crosspieces and rods.

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To restore the damaged vertebrae, bone grafts are used.

In the postoperative period, rehabilitation activities are carried out, including regular exercises of exercise therapy, massage and physiotherapy.

Prognosis for compression fractures of the spine

With fractures of 1 degree, timely adequate treatment and strict adherence to the recommendations of the doctor, the prognosis is favorable, especially at a young age.

The ability to work is fully restored.

At fractures of 2 and 3 degrees in the long-term period pains are possible, the probability of development of an osteochondrosis, a radiculitis and intervertebral hernias increases.

A source: http://www.krasotaimedicina.ru/diseases/traumatology/spinal-compression-fracture

What is a compression fracture of the spine?

Everyone knows that spine injuries are dangerous for human health and life, but few people understand their varieties, so for example, what is the compression fracture of the vertebrae and what is its difference from the usual, only one of ten of the respondents.

Compression is the squeezing of the object, so the compression fractures of the vertebrae come from squeezing their bodies, accompanied by twisting, flattening and cracking, but without compromising integrity. Very often occurs in the elderly. Suffer not only one particular vertebra, fractures 2 and even 3 vertebrae at the same time - this is a fairly frequent phenomenon.

When the vertebra was injured, but remained in its position, then such compression damage Stable, with an offset of the vertebra, an unstable fracture is observed, requiring operation.

Compression fractures of the cervical spine are rare, usually due to a car accident or a high altitude fall. The complete opposite of this trauma is the decompression fracture of the spine, it appears due to the extension of the ridge.

Causes

Often the compression fracture of the vertebra becomes the result of a jump from the height when landing with straight legs or a gluteal region, those who engage in extreme sports (bungee jumping, parachute jumping, etc.) should especially know how to help with such damage. Car accidents and incidents in the workplace lead to similar damage much less often.

If the cause of the fracture is the usual fall, then its consequences are damage 1, rarely two vertebrae.

If there was a trauma as a result of the action of strong kinetic energy, then there may be additional fractures, craniocerebral trauma, slaughter of the thorax, stomach and viscera.

To compression injuries of the ridge in old people can cause even weak tremors or sharp slopes due to age-related degradation and weakening of bone strength.

If there are multiple fractures, then eventually, diagnosis of age-related kyphosis can also "grow" a hump, due to a strong underestimation of the height of the vertebrae in the fore parts of the ridge.

Another type of pathological injury of the ridge can be called compression injury in cancer with bone metastases.

Classifier

The severity of deformation of the vertebra is distinguished by 3 degrees of compression fracture:

• Fracture of 1 degree - reduction of the vertebra by more than 50% in height;
• Fracture of the 2nd degree - the vertebra is reduced by 50%;
• For a grade 3 fracture, the vertebra is contracted by 51 or more%.

Compression fracture of the spine is complicated and uncomplicated. For the first, there is a neurological disorder.

Very dangerous is the splinter fracture of the spine because of the high risk of damaging the roots of nerves with bone fragments.

Such damage occurs after a while, first as a decrease in sensitivity in the legs with a smooth transition to numbness.

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Uncomplicated fracture of the ridge can not especially disturb the injured person at first, giving him only a small inconvenience in the form of constant tolerable pain. The consequences of inactivity and delay in referring to the treating doctor in such cases is radiculitis or osteochondrosis.

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In appearance, vertebral fracture, such trauma is divided into:

• Wedge-shaped. The body of the vertebra is flattened into a wedge from one side. The wide part of the "wedge" is directed to the central canal, and the narrow part to the sternum;
• Compression-detachable. This type of compression fracture of the vertebral body is accompanied by a detachment of the antero-vertebral part of the vertebral body. Determine such a fracture is possible on the X-ray image side view and axial CT;
• Fragments. The vertebra is compressed and distributed in breadth, dividing not several parts. Damage threatens the penetration of fragments into the spinal canal, which can lead to trauma to the spinal cord and nervous system disorders.

Diagnosis

Constant pain in the back is a sure sign of a compression fracture of the vertebra, although this is not a specific symptom, so the patient's words are not sufficient to establish a correct diagnosis. For the purpose of effective treatment and rehabilitation of compression fracture of the spine, additional studies are required:

• X-ray - a projection from the front and from the side helps to know how severe the injury and whether there are complications;
• CT - is done after X-ray examination for additional consideration of the injured zone;
• Myelography - assesses the general condition of the spinal cord after trauma;
• MTP - this type of diagnosis is prescribed by the doctor, when the trauma is affected by the elements of the spine;
• Densitometry is prescribed if the doctor suspects osteoporosis in the affected person.

It is from the correct diagnosis of the degree of fracture that depends on which doctor will apply the treatment of compression fracture of the spine, and how long the victim will be restored.

What are the consequences for preparing?

The consequences of a compression fracture of the spine without proper medical care can be fatal:

• Unstable position of the vertebrae in the affected area of ​​the ridge;
• Curvature of the ridge;
• Radiculitis, osteochondrosis;
• Stenosis of the spinal canal, which leads to disturbances in the activity of the central and peripheral nervous systems.

Such a fracture is very tricky, since the defeat of nerve endings does not occur immediately, but only after some time, as well as damaged vertebrae make the spinal canal already gradually, and this slowly intensifies such disorders as numbness of the limbs, general malaise, numbness. The aged compression fracture of the spine often causes the kyphus curvature of the ridge and the formation of the hump.

If uncomplicated fracture is diagnosed, then its consequences are not too dangerous, but trauma can become a "trigger hook" for other problems with the ridge - radiculitis, osteochondrosis.

Symptomatology

Common symptoms of compression fracture of the spine for all types of damage:

• Pains of varying severity, which have an increasing character;
• General weakness with dizziness and rapid onset of fatigue;
• Back pain during motor activity.

Injury of the thoracic or cervical spine is accompanied by difficulty breathing until it stops completely. For damage in the lumbar region is characterized by involuntary urination.

In itself, the cause of the fracture is already a characteristic symptom, that is, the injury is not due to flexion or extension, namely, when deformed by compression.

On the X-ray, you can see such signs of a compression fracture of the vertebrae:

• Changing the shape of the vertebrae into a wedge;
• Deformation of the anterior part of the vertebra;
• Subluxations in articulations between vertebrae;
• The space between the vertebrae increases.

First aid

The more correct the first aid will be rendered during compression fracture of the ridge, the more accurately the doctor will be able to determine the course of further treatment and how long it will take to rehabilitate. Unswerving behavior of others can lead the victim to a disability.

The first thing you need to pay attention to is the position of the victim during transportation.

The person should be transported lying on a firm platform or board, you should first fix the injured area and introduce painkillers (oral or intramuscularly).

You also need to fix the neck to immobilize the head. Such actions will prevent further damage to the vertebrae.

It is impossible to seat the victim, he should be exclusively in a lying position. You can not put him on his feet.

It is strictly forbidden to independently adjust vertebrae, extend limbs and give oral medication for problems with swallowing function.

Only intramuscular analgesics are resolved if the victim is unconscious.

Methods of treatment

How to treat a compression fracture of the spine and how much time it takes to rehabilitate can only be determined by a doctor, so do not hesitate to apply for qualified help and spend precious time on treatment in your home conditions.

Based on the severity of the trauma and the presence of possible complications, conservative or surgical treatment is prescribed.

Conservative treatment consists of such techniques:

• The fundamental. It is shown when no more than a third of the vertebral body suffered without neurological damage. Strict bed rest, correction of the shape of the ridge by longitudinal extension on an inclined shield, gymnastics for strengthening the muscles of the waist. Since more time is required to treat compression fracture of the spine in older people, special attention should be given to observance of rest. The course is one and a half to two months;
• One-time comparison of vertebrae in combination with wearing a corset with a fracture of the spine. It is prescribed when a vertebra is injured in the form of a wedge, with a decrease in its height not more than half. The doctor sharply unbends the spine and applies a fixation bandage. The procedure is performed under local anesthesia with X-ray in dynamics;
• Gradual comparison of vertebrae. The ridge is straightened on a rigid board using a recliner, a special device for stretching. The procedure is carried out several times with increasing amplitude of the extension of the ridge. Further, the spine is fixed with a three-point corset.

The basic surgical methods of treatment:

• Vertebroplasty is a laparoscopic intervention when a cementitious solution is injected into the body of the injured vertebra;
• Kypoplasty returns the vertebrae to natural height. Technically, the operation is similar to vertebroplasty with the additional introduction of a special implant with air lifting the vertebral body, followed by its fixation with a solution;
• Traditional surgical operation under general anesthesia, providing decompression of the spine and fixing traumatized areas with metal systems.

A source: https://PerelomaNet.ru/perelomy/kompressionnyj.html

Compression fracture of the spine: what is it, treatment and rehabilitation after trauma

Compression fracture of the spine is a common acute back injury, in which the vertebrae, intervertebral discs and other elements of the spine are damaged.

In the process of squeezing the elements of the structure described above, the impact generates symptomatic symptoms that can lead to a number of serious complications.

Therapy of an acute condition and the subsequent rehabilitation of a patient who is injured is performed in a hospital setting under the supervision of qualified medical personnel.

What is a compression fracture of the spine?

The human spine has a complex structure and consists of a number of elements.

As a result of the impact of the shock compressive load, the spinal segments and nerve endings are compressed: at the site of the fracture one or more vertebrae strongly compressed, which causes partial destruction of their anatomical integrity with a decrease height.

Such stable acute conditions are usually amenable to classical conservative therapy, complex forms of fractures lead to displacement of elements of the structures of the spine, the formation of negative consequences in the form of compression of the nerve roots, intervertebral discs and even the spinal cord - for their treatment requires operational intervention.

Frequent causes of such fractures

Almost always the direct cause of compression fracture of the spine is a stroke. Typical causes of compression fracture of the spine:

• Car accident;
• Jump into the water and hit the bottom;
• Landing on legs or buttocks from height more, meters;
• Occupation of injurious kinds of sports without proper protection of the spine from possible damage;
• Unintentional or willful strikes on the back;
• Work injuries, especially for high-rise and construction work;
• Household trauma;
• Other excessively strong and dynamic loads on the spine, when its sharp bending occurs.

In some cases, the fracture can cause not only shock dynamic, but also soft static loads on the spine.

As a rule, this situation arises if the patient is sick with osteoporosis, tuberculosis of bones, has chronic diseases of the musculoskeletal system or other problems of this spectrum.

Classification of compression fractures

Compression fractures, in the first place, are divided by severity:

• Fractures of 1 degree. The vertebra in the compression stage decreases in height by no more than 30%. Such an injury is considered relatively easy, the displacement of structural elements does not occur;
• Fractures of the 2nd degree. The vertebra under compression is destroyed in height by a parameter of up to 50%. This type of injury can lead to complications;
• Fractures of the 3rd degree. The vertebra is "flattened" by 60% or more. The most severe type of fracture, which almost always entails segmental instability of the entire spine, often requires surgical intervention.

In addition, doctors divide fractures into uncomplicated and complicated ones. In the first case, there are no neurological manifestations, the systemic functions of the spinal cord and nerve roots, as well as intervertebral discs, are usually not disturbed.

In the second case, compression of the vertebrae leads to destructive processes in neighboring segments, heavy or very serious consequences, as well as a significant increase in the time required for therapy and recovery patient.

Compression fracture of the spine usually has a clear localization in the thoracic, cervical, lumbar, coccygeal or sacral department, but there are also mixed injuries affecting several of the above-mentioned areas.

Symptoms and manifestations of compression fracture of the spine

To the general or common symptomatology at compression fractures of a backbone usually carry:

• Acute pain syndrome, which occurs immediately after the damage. More often it has a paroxysmal impulse character with alternating peak of pain and temporary relief. Less often the pain is deaf, grows slowly, but does not have periods of remission. Unpleasant sensations can give in the abdomen, groin, chest, between the scapula - depending on the place of injury;
• Strain of the muscular framework. With a fracture of the spine, the body tries to compensate for the instability of this system due to the smooth muscle work. Muscles are very tense, their movements are limited;
• Disorders of motor functions. With complicated forms of fracture, a person can not move independently, sit and even move using the vertebral system;
• Weakness in the limbs, partial or complete paralysis. If the upper or lower part of the spine is damaged, the sensitivity of the hands and feet, respectively, may be absent;
• Impaired breathing and palpitations. The shock state and a number of destructive processes primarily affect the work of the cardiovascular and respiratory system. In some cases, the patient is required to perform artificial respiration and indirect cardiac massage;
• A variety of neurological symptoms. Appears with complex fractures of high degree, expressed in confusion and disturbances of consciousness (up to coma), involuntary urination, defecation and vomiting.

Diagnostics

Qualified diagnostics is an important stage before beginning treatment of compression fracture of the spine, which allows to choose the right therapy scheme correctly.

Immediately after entering the hospital, the doctor will conduct a primary examination of the patient, if possible, collect anamnesis and learn about the circumstances preceding the formation of an acute condition.

Then he will palpate possible fracture zones, and also check a number of reflexes: nerve root tension, tendon work, muscle strength, limb sensitivity.

Based on these data, the doctor can make a primary diagnosis.To confirm the diagnosis, instrumental examinations are necessary:

• Radiography. A snapshot in 2 projections gives an opportunity to see the site of the fracture and in general to assess its degree and complexity;
• CT scan. Allows you to carefully examine the identified lesion for damage to all components of the spine structure;
• MRI. It barked the opportunity to investigate the damage to the nerves and spinal cord, if any;
• Myelography and densitometry. Are appointed to identify possible complications or background diseases, which are an additional negative factor for the recovery of the patient.

Complications and consequences of trauma

Compression fracture of the spine can lead to the most serious consequences and complications, some of which even threaten the patient's life, not to mention health.

• Segmental instability of the spine. It leads to uncompensated degenerative changes in the structure of soft tissues and all components of the vertebrae. In the medium term, it provokes the development of disability;
• Kifotic deformation of the spine with the formation of extreme stages of scoliosis;
• Persistent partial or complete paralysis of the limbs due to significant damage to the spinal cord;
• Violations of a number of related systems and organs;
• Death.

Features of compression fractures in children

Modern medicine rarely diagnoses a compression fracture of the spine in children under 8 years old. In this period, all structures of the musculoskeletal system of babies are very flexible, have a good degree of regeneration.

Starting from the age of 8, the chances of getting such an acute condition increase significantly, picking up a peak to 11-13 years - the period of maximum motor activity. The skeleton of a teenager has already grown stronger, although it continues to grow, and is prone to compression processes even under impact loads of moderate strength.

An additional negative factor can be chronic problems with the musculoskeletal system, for example, scoliosis, which developed behind the school desk with an incorrect position of the body in class.

The treatment of children with compression fracture of the spine practically does not differ from adult therapy.

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As a rule, this process is easier for adolescents to transfer, and recovery is faster because of shortened rehabilitation periods, which averagely average 4 weeks.

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Children for pain relief are not prescribed narcotic analgesics, after discharge from the hospital the chances of repeated relapses problems, the formation of segmental instability of the spine are minimal, naturally, in the case of qualified treatment and rehabilitation.

First aid

Any person who has a suspicion of compression fracture of the spine, you must provide first aid before the arrival of a team of doctors.

• Immediately after the accident, the victim must be placed in a horizontal position on a hard surface. It can not be moved and raised only if its current location does not endanger the patient's life;
• Call an ambulance team, as accurately describing the symptoms and condition of a person, and also suggesting a possible fracture of the spine in the latter;
• Under a potentially damaged area, place small rollers of soft cloth (can be made from improvised materials, for example, clothes);

Carry out a basic diagnosis of the patient. Consciousness, absence or presence of pain syndrome, pulse - these parameters are important for your further actions.

• If a person is conscious and his swallowing reflex normally functions, give the patient any painkillers that are at hand. To the site of the fracture, dry cold can be applied: ice, wrapped in a rag, bottles with cold water. If the street is cool, be sure to cover the victim, in order to prevent the supercooling of the body;
• With a serious complicated spinal fracture of 2 or 3 degrees, often a person can lose consciousness, he begins to manifest neurological symptoms. The breath stops and the pulse disappears. Regularly check the airways, delaying possible tongue lagging and clearing airways from vomit, if any. Otherwise, the victim may suffocate or choke;
• If the patient lacks pulse and breathing, go to resuscitation. It is necessary to carry out artificial respiration (pinch the nose to the victim, inhale through his mouth a previously collected portion of air and immediately unclose the nose) and heart massage (rhythmic jerks with both palms with linked fingers in the lower third of the sternum, about 30 clicks in 20 seconds, followed by a transition to artificial respiration with 2 approaches) before the arrival of the brigade physicians;
• A patient is transported with such a fracture on a hard (face up) or soft (abdomen down) stretcher, with maximum immobilization. Before transport to damaged areas, you must put tires, shift from the ground to a stretcher should be very carefully, synchronously, supporting all parts of the spine, neck and head in a natural position.

Treatment of compression fracture of the spine

Complex treatment includes:

• Conservative drug therapy. Injection of pain medications, droppers with saline solution and glucose, other medications according to vital indications (epinephrine, corticosteroids, etc.)
• Manual therapywith vertebrae adjustment, as well as stretching the spine on a special couch with exercise, observing strict bed rest.
• Operational activitieswith segmental instability and complicated vertebral fractures. An experienced surgeon will clean the area of ​​the fracture from the fragments, if necessary, will soften the tissues, perform kyphoplasty or vertebroplasty (introduction air microballoons for decompression, fixation of the affected vertebra with medical cement), in rare cases, replace the vertebra with prosthesis.
• Other actions, painted according to an individual scheme, depending on the complexity of the injury, the current status of the patient, the presence of complications and other factors.

Rehabilitation and exercise therapy for compression fracture of the spine

The average period of rehabilitation after a compression fracture of the spine in an adult is about 8 weeks. The complex of rehabilitation measures usually includes:

• Limited physical therapy. It is necessary to maintain the tone and normalization of metabolic processes. In the first 10 days is carried out without any mobility of the body directly on the couch. From 2 to 4 weeks, the intensity of exercise increases, the list of exercises is expanded, they can be conducted with an emphasis on the knees. The last stage is full-length exercise therapy with moderate back pain. All exercises in the compression fracture of the spine are prescribed by the doctor.
• Massagewith a compression fracture of the spine. It is necessary to restore the smooth muscles, fixing the effect of straightening the spine.
• Corsetwith a compression fracture of the spine. It can be used in the last stages of rehabilitation, when the spine has almost recovered, but its support is still necessary. The plaster corset applied to the lesion area allows to increase the mobility of the victim without damage to the rehabilitation process.
• Physiotherapy. A full range of physiotherapy procedures includes the application of electrophoresis on novocaine, nicotinic acid, UHF, inductotherapy, UFOs, cryotherapy, balneological procedures, diadynamic therapy, myostimulation, magnetotherapy, as well as paraffin-ozocerite applications for damaged sites.

A source: https://1travmpunkt.com/perelom/pozvonochnik/chto-takoe-kompressionnyj-perelom.html

Compression fracture of various parts of the spine

During the fracture of the spine, the integrity of its structural elements, vertebrae, is disturbed. Mechanisms of vertebral fracture may be different.

This is flexion-extension (flexion-extension), rotation (rotation around the longitudinal axis) and compression (compression, compression) of the bodies and spines of the vertebrae.

And the last kind, a compression fracture of a backbone, in clinical practice meets more often. The same pearl is the most dangerous in terms of possible complications.

Causes

In order for the compression fracture of the spine to "successfully" form, it is necessary to have at least one of two factors.

This is an external effect, the strength of which exceeds the strength of the bone tissue of the vertebrae, or the initial weakness, failure of this tissue.

Most often there is a first option - trauma, the main causes of compression fracture of the vertebrae.

The mechanism of injuries can be different. Most often it is:

• Fall from height to back;
• Falling from height to feet or to the buttocks;
• Strong blow in the back;
• Fall from the height to the back of a heavy object;
• The head thrust during diving, "diver's trauma" is the most common cause of compression fracture of the cervical spine.

In certain pathological conditions, a change in the structure, a decrease in the density of the bone tissue of the vertebrae, is possible. In these cases, to obtain a compression fracture, a minimal external impact is sufficient, absolutely not dangerous for healthy people.

Such compression fractures are called pathological. Most often they are a consequence of osteoporosis - a decrease in strength and density of bone tissue. Sometimes, pathological compression fractures can result in tubercular and tumor lesions of the vertebrae.

Symptoms

A distinctive feature of the compression fracture of the spine is a decrease in the height of the vertebral body under the action of compression. It was this feature that formed the basis for the classification of the compression fracture. According to this classification, 3 degrees of compression fracture are distinguished:

You can also read:
First aid for a fracture of the spine

• Fracture of 1 degree - the height of the vertebral bodies decreased by less than 30% of the original;
• Fracture of the 2nd degree - the height decreased by more than 30%, but less than 50%;
• A grade 3 fracture is a decrease in the height of the vertebrae by more than 50% of the original vertebra.

Along with the vertebral bodies in the compression fracture, their arches often suffer. Compression fractures are single and multiple, respectively, with damage to one or more vertebrae.

In addition, stable and unstable compression fractures are distinguished. In the first case, the whole and damaged vertebrae do not move relative to each other, and the overall structure of the spine is not disturbed.

In unstable compression fractures, the vertebrae are displaced, and the so-called spinal cord is formed. fracture.

The main symptoms of compression fracture of the spine:

• Pain in the fracture site;
• Visible deformation of the spine;
• Local edema of soft tissues;
• Limitation of volume or complete absence of movements in the spine;
• Scrapes or bruised skin wounds in the fracture region.

Neurological complications

This is how the wedge-shaped deformation of the vertebral body looks schematically in the compression fracture

But the main danger at a fracture is not in damage to the vertebrae, and not even in possible bleeding.

As a result of compression, a wedge-shaped deformation of the vertebral bodies is formed, which in the longitudinal section take the form of a wedge-a triangle, turned with a base towards the spinal canal.

This vertebra is displaced towards the canal and damages the spinal cord located there. Especially dangerous in this regard are unstable compression fractures.

Compression fracture of the lumbar spine is fraught with paralysis of both lower extremities (lower paraplegia) and loss of control of the pelvic organs.

True, in adults less than the 1 st lumbar vertebra, the substance of the spinal cord is absent. But here there is a powerful neural bundle, the so-called.

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ponytail, giving sensitive and motor fibers to the skin, muscles, pelvic organs, lower limbs.

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Compression fracture of the thoracic spine and concomitant spinal cord injury along with previous symptoms occurs with shortness of breath, a decrease in sensitivity in the chest, in the back and abdomen, in violation of the tone aperture. And if the spinal cord is damaged in the cervical region, all groups of muscles of the four limbs (tetraplegia), the abdomen, and the thorax are turned off. This leads to difficulty breathing and the need to transfer the patient to the artificial ventilation of the lungs.

And so the vertebra deformation looks on a computer tomogram

Treatment

To treat a patient with a compression fracture of the spine, you should immediately after receiving an injury. Correct and timely transportation to the profile medical institution is also a kind of treatment. Errors at this stage can be costly.

Displacement of fragments at the stage of admission to the hospital can lead to neurologic complications, even in cases when they were not originally there.

To avoid complications, the patient is laid on his back (not on his side, or on his stomach) on a flat hard surface.

Necessarily prescribed painkillers - Ketanov, Analgin, Renalgan.

With concomitant spinal cord injury, specific drugs are used to improve blood circulation and metabolic processes in the spinal cord - Pentoxifylline, Trental, Actovegin.

Even in the absence of damage to the spinal cord, patients with a compression fracture during the first weeks are shown a strict bed rest. Subsequently, minimal motor activity is allowed.

In this case, the patient is recommended to stand or walk in the main - do not sit. At this time, a special corset is shown. Corset by immobilization (immobilization) stabilizes the damaged spine.

Use corset need at least 2 months. from the time of injury.

In the compression fracture of the cervical vertebrae, the Shantz collar is used as an immobilizing device

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After, months. Since the beginning of the injury should be carried out rehabilitation. A light massage is performed, physiotherapeutic procedures - UHF, a magnet, electrophoresis with calcium.

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In the absence of complications and severe concomitant diseases, complete consolidation of the fractured vertebrae occurs approximately 3 months. After that, the restoration is carried out for half a year. Courses of massage, physiotherapy procedures are continuing.

In order to strengthen the muscles of the back and expand the volume of movements, sparing physical loads are shown in the framework of therapeutic physical training.

on the causes and mechanisms of development of compression fracture of the spine:

Compression fractures of the third degree, heavy splinter fractures of the vertebral bodies, concomitant spinal cord injuries serve as indications for surgical intervention.

and with the use of modern synthetic materials capable of replacing damaged bone tissue.

A source: http://MoyaSpina.ru/bolezni/kompressionnyy-perelom-razlichnyh-otdelov-pozvonochnika