Fractures of the lumbar spine: first signs, causes, symptoms, diagnosis, treatment and recovery

2024 Author: Curtis Blomfield | [email protected]. Last modified: 2023-12-16 20:44

Fractures of the lumbar spine are more common than others. It is this part of the skeleton that experiences the maximum load. Strong compression, trauma or physiological changes in the bone tissue provoke its destruction. In addition to the supporting apparatus itself, the spinal cord and soft tissues can also be damaged. Treatment of pathology should begin immediately to avoid complications and disability.

Reasons for appearance

Fracture of the lumbar spine can be obtained at work, at home, on the street. It can be provoked by such negative factors:

• accident.
• Falling from a great height landing on the buttocks or straight legs.
• Gunshot wound to spine.
• Sports injuries.
• Anemia.
• Malignant tumor in the lumbar region.
• Increased bone fragility due to poor absorptioncalcium.
• Bone tuberculosis.
• Lymphoma or leukemia.
• Decrease in bone density due to the use of large amounts of glucocorticosteroids.
• Age-related aging of the spine.
• Long hunger strike and malnutrition.
• Calcium leaching from the body due to thyroid pathologies.
• Sagging of the intervertebral cartilage.

Fractures of the lumbar spine occur due to degenerative changes in tissues that develop due to insufficient functioning of the kidneys, problems with the endocrine system.

Injury classification

Fractures of the lumbar spine are different. They are classified according to several parameters (see table below).

Criterion	Types of Damage
Degree of difficulty	Uncomplicated. In this case, the nerves and spinal cord remain intact. Complicated. Nerve structures are severely compressed or destroyed
According to the etiological factor	Traumatic. It occurs when a certain force is applied. Pathological. Develops due to degenerative disease
Based on the characteristics of the injury	Compression. It appears as a result of severe compression of the vertebrae. There are 3 degrees of this pathology: at the first, the vertebra decreases to 1/3 of its height, at the second - up to 1/2, at the third - more than half. With such a fractureintervertebral discs and bone processes suffer. Splintered. This is where the bones are destroyed. In most cases, this requires surgery. With such an injury, soft tissues are also damaged. With offset. Here the damaged parts are shifted to the spinal canal or in the opposite direction. In this case, a person will experience partial or complete paralysis of the legs. Fracture dislocation. This option is the most difficult, as a complete rupture of the spinal cord can occur

Fracture of the spine in the lumbar is a difficult injury that requires inpatient treatment. Moreover, its duration is 3-4 months - a year.

Symptoms of pathology

Fracture of the thoracic and lumbar spine has certain symptoms. In the first case, the injury is characterized by the following manifestations:

• Acute severe pain that eventually spreads to the perineum, legs.
• Unconscious.
• Nausea and vomiting.
• Traumatic shock.
• General mobility disorders of the vertebrae.
• Work and bowel problems.
• Muscular weakness in lower limbs.
• Skin numbness.
• Desensitization in the legs.
• Paralytic ileus.
• Partial or complete paralysis of the legs.

In ICD-10, a lumbar spine fracture is coded S32.0. If the injury wears a light compressioncharacter, then a person is able to move, but he is lame. Problems with the functionality of the genitourinary system also begin.

Diagnosis of pathology

Before starting treatment of a compression fracture of the lumbar spine (as well as its other form), the patient must undergo a thorough examination. It provides:

• Collecting an anamnesis and data on the injury (if the patient is conscious). Also, the specialist should carefully make a physical examination of the damaged area.
• Checking reflexes and neurological examination of the victim.
• X-ray. It will show the general condition of the damaged vertebrae. Research is being carried out in several projections.
• MRI or CT. This diagnostic technique is used if necessary. It shows the condition of not only bones, but also soft tissues, allows you to determine the damage to the spinal cord, the presence of hematomas, the placement of fragments.
• Myelography. Here the condition of the spinal cord is assessed.
• Densitometry - the study of bone density. Most often, the technique is used to diagnose women who have reached the age of 50. It is in this category of patients that osteoporosis is most often observed.

You also need to see a neurologist and a traumatologist. The consequences of a fracture of the lumbar spine can be very severe: impaired mobility, the functioning of internal organs, paralysis of the legs, or even death.

First aidwhen injured

Compression fracture of the lumbar spine is treated in a hospital. However, before the arrival of doctors, the victim needs to be assisted:

1. Lay on a horizontal hard surface (if the person is conscious). In this case, a roller is placed under the lower back, and a small hard pillow is placed under the head. It is important that the patient does not move, as fragments can be dislodged. If he is unconscious, then it is forbidden to change his position.
2. Turn your head to one side and fix it in this position. This way you can avoid retraction of the tongue and blocking of the airways (including vomit).
3. Constantly monitor your breathing, pulse and blood pressure.
4. Constantly talk to the victim so that he does not fall asleep before the arrival of the doctors.
5. If possible, a wide splint should be placed on the broken section of the spine.

Until the doctors arrive, the person is not allowed to give any medicine.

General principles of therapy

Treatment of a fracture of the lumbar spine involves an integrated approach. The victim needs:

1. Medicines. Painkillers are most often used here. Multivitamins are also needed to improve bone and cartilage nutrition.
2. Surgical intervention (in the presence of large destruction of the lumbar vertebrae).
3. Physiotherapy and physicalactivity. Any movements in the first weeks should be limited. Heavy lifting is prohibited for a long time.
4. Using a supporting corset. It will allow you to remove excess load, support the spine in the correct position.

Proper therapy will allow the patient to recover faster.

Surgery

It is prescribed for medical reasons. Surgery is needed if:

1. There is instability of the vertebrae.
2. There is a significant amount of bone fragments.
3. Conservative therapy does not give a positive result.
4. There is excessive pressure on the soft tissue at the fracture site.
5. Splinters damage the spinal cord, impairing its functionality.

There are several types of surgical interventions:

• Kyphoplasty. A special balloon is inserted into the damaged vertebra, with the help of which a certain space is created in it. After removing the device, the void is filled with special bone cement. This allows you to fasten the vertebra, increase its density, restore height.
• Vertebroplasty. A special cementing agent is injected into the vertebra using a special metal rod.
• Radical implant surgery. It is necessary for severe destruction of vertebral structures, as well as for nerve damage.

Surgery is a last resort. After it, rehabilitation is also needed.

Massage for a fracture

Massage for a fracture of a vertebra in the lumbar region is almost always performed. The patient needs the following exercises:

• Stroking (relaxes back muscles).
• Kneading (increases blood circulation in the injured area).

The movements of a specialist should not cause pain or other discomfort to the victim. The duration of the session is 15 minutes. Their number ranges from 10-15.

Using exercise therapy

Exercise therapy for a fracture of the lumbar spine is the main method of rehabilitation. It can be combined with breathing exercises. When moving the lower limbs, they must not be torn off the bed. You can't lift two legs at the same time either.

The duration of the workout does not exceed 15 minutes. The initial stage of rehabilitation is carried out for 15 days. In general, the course can exceed 12 months. At the second stage, the muscle corset is strengthened. Here the spine must be prepared for the intense loads of the final stage. Power loads are added last.

Exercise therapy should not be done if the patient has:

• Increased basal body temperature.
• There is always pain.
• There are manifestations of neuralgia.
• Asthenic syndrome has developed.

Any exercises are prescribed by a doctor and begin in a hospital under the supervision of a rehabilitation specialist.

Using physiotherapy treatments

To improve the result of conservative and surgical treatment, physiotherapy is neededprocedures. Beneficial for the patient will be:

1. Electrophoresis. It eliminates the pain syndrome, so it is carried out with the use of novocaine. The procedure accelerates the entry of other drugs into the damaged area. Conventional treatments cannot provide this effect.
2. Magnetic therapy. The procedure consists in treating the damaged part of the lower back with a pulsed magnetic field. The duration of one session is 15 minutes. At the same time, the pain goes away, and broken vertebrae recover faster.

Any warming procedures should be coordinated with a doctor, as with such injuries they may be contraindicated.

Features of using a corset

Corset for a fracture of the lumbar spine allows you to reduce the load on the damaged area. It can be semi-rigid, rigid with metal inserts, plaster. The choice of product is carried out by the doctor depending on the degree of complexity of the injury. There are also some rules for its use:

1. It is forbidden to wear the product on a naked body - there must be a T-shirt under it.
2. You should take it off before going to bed.
3. A specialist should adjust the device.

The corset will allow a person to start rehabilitation faster, restore normal mobility of the spine.

Possible complications and prevention

According to the ICD, a fracture of the lumbar spine is considered a serious injury, if left untreated, a person may experience the following complications:

• Intervertebral hernias.
• Paresis and paralysis of the lower extremities.
• Sex drive disorder in men and women.
• Urinary incontinence, diseases of the excretory system and genital organs.
• Infection.
• Sepsis.
• Spinal stenosis.
• Chronic spinal instability.
• Fat.

To avoid injury, it is better to take the following precautions: avoid falls, be careful while driving or at work, treat inflammatory processes in the skeleton in time. You should also harden the body and use multivitamin preparations to increase bone density. Engage in physical education to strengthen the muscular corset, prevent degenerative and dystrophic processes.

Fracture of the lumbar spine is a complex injury that requires the exact implementation of doctors' recommendations. Proper rehabilitation and timely treatment will quickly restore injured areas and return a person to a full life.