Fracture of the thoracic spine is considered one of the rarest skeletal injuries. The specified part of the musculoskeletal system is maximally protected from any type of injury. However, with an unsuccessful fall or as a result of a direct strong blow, 11 or 12 vertebrae can be fractured.
Causes for the development of pathology
Fracture of the thoracic spine has no gender differences. It is equally common in men and women. In elderly patients, injury can occur even with a slight mechanical impact due to the natural aging of tissues. The following negative factors can also provoke the disease:
- Traffic injury.
- Production accident.
- Unsuccessful fall from height landing on feet or back.
- Bone tuberculosis.
- Excessive axial load on the spine.
- Straight backstabsignificant force.
- The fall of a heavy object on the thoracic region.
- Lower bone density.
- Cancer of the spinal cord or metastases.
- Injury sustained during childbirth.
- Osteomyelitis.
Provoke the appearance of a fracture of the thoracic spine may be taking certain medications. As a result of their impact, bone density decreases.
Disease classification
Thoracic spine fractures are different. You can classify them like this:
| Parameter | Types and their characteristics |
| Severity |
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| Etiology |
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| Number of damaged vertebrae |
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| Pattern of damage |
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Treatment of a fracture of the thoracic spine is carried out only after a thorough examination.
Symptoms of pathology
Symptoms of a thoracic spine fracture are usually severe. They are clearly felt when trying to change the position of the body, as the displacement of the fragments affects the nerves. Common signs of injury are:
- Weakness in the limbs, their numbness. In severe cases, paralysis develops.
- Sharp severe pain.
- Problems with urination (retention).
- Suffocation.
- Intestinal paresis.
If the pathology appeared as a result of an injury, then the signs are as follows: a sharp pain syndrome, neuralgic symptoms, congestion in the respiratory system, pneumonia.
Diagnostic features
Before starting the treatment of a fracture of the thoracic spine, the patient needs to be diagnosed. First, the doctor interviews the victim and collects his medical history. When diagnosing, only hardware methods are used, since laboratory tests will not give a result.
The patient is assigned;
- X-ray. It is done in two projections. On the picture you can clearly see the type of fracture, as well asthe presence of displacement, fragments.
- CT. This study is considered the most informative. It layer-by-layer shows the state of not only bones, but also soft tissues. Thanks to this diagnosis, the level of instability of the vertebrae, hemorrhage in the spinal cord, compression of the nerve roots is determined.
- MRI. Thanks to this diagnosis, it is possible to accurately determine the location of the lesion, as well as the need for surgery.
- Electrophysiological diagnostics. It is required if there are fragments.
Fracture of the thoracic spine in children requires emergency care. Before the arrival of doctors, the victim should be tried to calm down.
First aid and possible complications
Treatment of a compression fracture of the thoracic spine is also a complex procedure. In case of traumatic injury, which is accompanied by shrapnel, a person needs to provide first aid and call an ambulance.
First of all, the patient's mobility should be limited so that the vertebrae do not move and do not pinch the spinal cord. The victim is laid down on a hard and flat surface: a stretcher or the floor. The person should lie on their back. It is better if the entire body of the victim is placed on the plane. To reduce the likelihood of swelling, put ice on the affected area.
In the presence of severe pain, the patient can be given the analgesic "Ketonal". It is better to inject the drug intramuscularly. He should not be given any other drugs. If a person has lost consciousness, before the arrival of doctors, you need to monitor his breathing and heartbeat. So that the tongue does not sunk, the head is betterturn sideways.
If left untreated, the consequences of a thoracic spine fracture can render a person disabled. However, they appear immediately after injury or in the distant future. If the spinal cord and nerve roots are damaged, a person may lose the ability to move at all.
Complications of a fracture are:
- Infection of the damaged area, resulting in osteomyelitis.
- Chronic pain in the future.
- Kyphosis (curvature of the spine).
- Kyphoscoliosis.
- Sciatica of the chest.
- Osteochondrosis.
- Pulmonary embolism.
- Spinal stenosis.
- Herniated discs.
- Rupture of ligaments.
- Violation of the functionality of organs adjacent to the injured area.
Segmental instability of the vertebrae may occur due to a fracture in the thoracic region.
Conservative treatment and physiotherapy
Treatment of a compression fracture of the thoracic spine or shrapnel injury at first is performed in a hospital. It involves the use of medicines, physiotherapy procedures.
The choice of methods depends on the severity of the disease. Typically, the patient requires the following therapies:
| Method | Characteristic |
| Blockade | It is necessary to eliminate severe pain whenvertebral displacement. Novocaine and lidocaine are most commonly used. In difficult cases, narcotic analgesics are needed |
| Medications |
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| Spine traction |
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| Massage | He is assigned to all victims without exception. There are several types of massage: acupressure (impact on biologically active points responsible for the functioning of internal organs), classical (involves stroking, shaking and patting of varying intensity). Reflex massage is also used in the therapeutic scheme. In this case, not involvedpoints, but biologically active zones |
| Physiotherapy treatments |
Used to restore damaged tissue faster and restore mobility. The following procedures will be useful for the patient:
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After completing a course of conservative therapy, the patient needs rehabilitation after a fracture of the thoracic spine.
Features of food
In order for the recovery phase to pass quickly and without complications, the victim needs to eat well. His diet contains foods rich in calcium, magnesium, phosphorus, zinc. Vitamins D, B are also needed. The menu must include:
- Milk, lean fish and meat (provide protein and calcium).
- Sour cream, eggs, fish oil, butter.
- In case of a fragmentation or compression fracture of the thoracic spine, rehabilitation provides for the rejection ofcoffee and strong tea, alcohol, carbonated drinks, as they flush out calcium from the body.
If you follow the recommendations of doctors, recovery will pass without complications.
Surgery
Necessary in the absence of a positive effect from conservative therapy. There are several types of operations assigned to the victim:
- Kyphoplasty. This is a minimally invasive procedure that requires general anesthesia. It is needed if it is necessary to restore the geometric proportions of the vertebra. A balloon is inserted into the damaged area, which is gradually filled with liquid. After a cavity is formed in it, the device is removed. The void is then filled with thick bone cement.
- Vertebroplasty. The intervention requires local anesthesia. A small incision is made above the damaged area, through which a metal conductor is inserted into the damaged area. Through this device, polymethyl methacrylate enters the fracture site. The cement must be injected on both sides of the vertebra.
- Implantation. It is shown only with significant destruction of the vertebrae. During the operation, an artificial implant is used. It must be high quality and hypoallergenic.
Surgery is the last option. It should be carried out in the first few days after the patient is injured, always under sterile conditions.
Rehab
Includes physiotherapyprocedures and physical therapy. The recovery period provides for the elimination of spasms and pain, strengthening the muscle corset. This requires not only physical exercises, but also breathing exercises.
Exercise therapy for a fracture of the thoracic spine is first done in the supine position. Rehabilitation can be divided into several stages:
- Initial. Lasts 2 weeks. Provides exercises that tone the body and muscles, as well as breathing exercises. They are carried out in the supine position. In this case, the patient needs to use the upper and lower limbs. It is forbidden to take your legs off the bed. Exercises for a fracture of the thoracic spine at this time are as follows: clenching the fingers into a fist, bending the arms at the elbows, circular movements of the limbs in the shoulder joints, alternately abducting the arms to the sides. After completing the complex, you need to restore breathing. Repeat up to 4 times a day, duration is 15 minutes.
- Second. Duration - a month (in uncomplicated cases - 2 weeks). Here the spinal muscles are strengthened, regenerative processes are stimulated. Exercises are performed in the supine position. The complex includes: flexion and extension of the arms spread apart, flexion of the legs with their straightening at a small height above the bed; raising the shoulders and head; imitation of cycling. Gradually, the intensity of the load will need to be increased. It is important to remember that sitting in this position is prohibited for 2 months.
- Final. There are already added exercises in the kneeling position andon all fours. The following exercises are assigned to the victim: semi-squats on toes with an emphasis on the crossbar; moving legs back in turn; walking on your knees back and forth or in a circle. Thanks to such physical education, the mobility of the spinal column, its flexibility, and the stabilization of posture are restored. Intensive classes are performed up to 3 times a day for 40 minutes. The course lasts 1 month. The next 60-90 days, the load is reduced, the exercises are performed only once a day. For some patients, the rehabilitation course is extended for a year.
At the end of the recovery course, a person needs to do fitness in order to maintain the muscles and the spine itself in optimal condition. Swimming will be beneficial for the body, as it restores the functionality of the skeleton without unnecessary load.
Fracture prevention
Any disease is better to prevent than to cure. In order not to get an injury to the thoracic region, it is necessary to observe the following preventive measures:
- Prevent any possibility of falls and injury.
- Be extremely careful while driving.
- Observe safety measures at work.
- Strengthen your back and chest muscles with exercise. Swimming pool is very useful.
- Eat right so that the body receives a sufficient amount of nutrients. It is better to remove fatty foods and foods high in preservatives from the diet.
- Quit smoking, alcohol abuse, coffee drinks, as this leads to a decrease in densitybones.
- Timely treat any infectious or inflammatory processes that lead to the development of degenerative-dystrophic processes in the skeleton.
The prognosis of a thoracic fracture is difficult to construct. It depends on the severity of the injury, the age of the victim, the timeliness of first aid, as well as the correctness of therapy and rehabilitation. But even after minor damage to the vertebrae, a person will have to limit his mobility for some time. The older the patient, the worse the prognosis. Even more damaging is the repeated injury to the thoracic region.
A fracture of the thoracic spine is difficult to obtain, but also difficult to treat. Without timely therapy, a person may experience complications that cannot be eliminated without surgery. The recovery period is also very important. Here you need to strictly follow all the instructions of specialists.
