Pronouncing the diagnosis of "fracture in the spine", the doctor, as it were, reduces the severity of the injury. This is dangerous because the patient begins to think that his condition will not lead to complications. Spinal cord injuries, including a fissure in the spine, are far from trifling, and complications can be quite complex and unpredictable. In this case, a crack is not a microtrauma, but a fracture of the vertebra, which occurs due to compressive compression. An incomplete fracture looks like a thin wavy line on X-ray, which is why it is called a fissure.
Structure of the spine
The spine has cervical, thoracic and lumbar sections, in these sections there are 24 movable vertebrae and 10 fixed ones. The vertebrae overlap each other and form a canal, inside which the spinal cord is located. Such protection is provided due to the fact that the spinal cord is a very important organ of the nervous system.
Thus, the spine in the human body performs not only a musculoskeletal function,but also protective and connecting:
- protects the spinal cord from damage;
- connects the spinal cord to the brain;
- provides a vegetative connection between all human organs.
Is it scary - a crack in the spine? Of course, this is a very dangerous injury that can lead to damage to the spinal cord, and the consequences of this are not only unpredictable, but also irreparable.
Types of injury lurking under an incomplete spinal fracture
The very complex design of the spine opens up a vast field for injury diversification. As a rule, injuries are distinguished by the type of damage and the location of the site of damage.
By the nature of the spinal injury can be:
- closed - the injury did not damage the soft tissues that cover the spinal column;
- open - there is a violation of the skin and tissue.
As for the localization of the injury, it can be as follows:
- damaged vertebral body;
- damaged vertebral processes;
- arc broken.
Quite often a crack in the spine leads to damage to the spinal cord, then doctors talk about the following degrees of damage:
- First degree. All functional disorders are reversible, in other words, there was a concussion of the spinal cord.
- Second degree. Functional disorders are irreversible - there was a contusion of the spinal cord or its contusion.
- Third degree. There is compression of the spinal cord. That is, the organ is compressed as a result of deformationspinal hematoma or tissue edema.
Based on the above, we can conclude that a crack in the spine is a closed injury that can touch any of its structural parts. And despite the fact that this is a very dangerous condition, serious and irreversible spinal cord injuries in this case are diagnosed in rare cases.
Etiology of the phenomenon
If we turn to statistics, then spinal injuries account for about 10-12% of all injuries related to the musculoskeletal system. As a rule, a crack or compression fracture of the spine in children and adults occurs when falling from a height or in car accidents. As for the elderly, they may experience a similar phenomenon even with minor physical exertion.
Characterization of injury
Incomplete vertebral fracture most often occurs with compression-related injuries. Damage to the vertebrae can occur when safety precautions are not followed, when heavy objects fall on a person, when falling from a height and in accidents. The specificity of an incomplete fracture is that often it does not attract the necessary attention. The functions of the body in most cases are not disturbed, and the person does not see the need for treatment. This is the deepest delusion - absolutely any spinal injury must be treated and corrected in the most thorough way, otherwise dangerous complications are possible.
Symptoms
The clinical picture of pathology depends onseverity and location of injury. Most often, the patient complains about the following:
- Sharp pain that gets worse with bending and turning.
- If the damage has touched the 3rd and 4th cervical vertebrae, pain occurs when turning the head, which prompts the person to take a forced position in which the cervical muscles are maximally tense. If the 1st and 2nd vertebrae are damaged, an instant lethal outcome of the victim is possible, as the spinal cord is compressed.
- A fissure of the spine in the lumbar region provokes girdle pain, and the pain also increases on palpation.
- If the fissure is localized in the thoracic spine, the pain will also have a girdle character, there may also be signs of pathology of the lungs and heart - tachycardia, shortness of breath, shortness of breath.
In case of an incomplete fracture of the spine, pinned heel syndrome may occur. If the patient is lying on his back on a hard surface, he cannot raise his leg without bending the knee.
When a compression injury occurs, there is a violation of motor activity, malfunctions of internal organs, and a decrease in sensitivity.
First Aid
Since a fracture in the spine can have very serious consequences, the victim needs professional help as soon as possible, so the first thing to do is call an ambulance.
Independent attempts to move the victim or attempts to transport him to the clinic can lead to dangerous complications. Therefore, before the arrival of a team of doctors, a person must be laid on a hard surface. If there is none, it is necessary to turn the patient face down on a soft surface. Under the chest you need to put a roller from a blanket or pillow. It is necessary to move the victim very carefully, while remembering that any wrong movement can cause harm.
In case of damage to the cervical spine, it is necessary to fix the damaged area with a splint or a soft collar. It is better not to give the victim painkillers until the doctors arrive, so as not to blur the clinical picture. Painkillers are allowed for patients with a low pain threshold.
Diagnostic measures
The spine doctor cannot determine the crack, so the damage is diagnosed by X-ray. In the picture, the specialist sees a crack in the form of a thin line. If there is a need to clarify the features of the damage, the doctor may prescribe magnetic resonance imaging.
If no damage to the spine was found during the study, but the patient has alarming signs, additional diagnostics are prescribed, for example, a blood and urine test to detect an inflammatory process.
Consequences
Disorders of the visceral-vegetative nature, as a rule, are observed not immediately after the injury, but after some time. For example, the formation of trophic ulcers, which are provoked by impaired blood flow in all types of spinal cord injuries.
On the part of the internal organs canobserved in cervical injuries:
- headaches and dizziness;
- vomit;
- respiratory failure;
- respiratory paralysis.
For chest injuries:
- gastric or duodenal ulcer;
- diseases of the heart and blood vessels.
For lumbar injuries:
- kidney failure;
- problems in the colon or bladder.
How is a crack in the spine treated?
Treatment of spinal injuries should be done on an emergency basis. May be conservative or surgical. It depends on the severity of the injury.
In case of a mild injury, in which there is no displacement or prolapse of the vertebra and its fragments, as well as in the absence of damage to the spinal cord, it is prescribed:
- wearing a corset for several months;
- pain therapy.
During the rehabilitation period it is recommended:
- special set of exercises;
- physiotherapy;
- treatment with ozocerite or paraffin applications.
If the crack provoked deformation or destruction of the spine, it is prescribed:
- Extraction of the spine to give it an anatomically correct position.
- Surgery to restore the vertebrae. If this is not possible, an artificial implant is placed.
- When complications and purulent infections occur, drug therapy is carried out.
For severe and severe spinal cord injuries, the treatment is very long and is as follows:
- Restoration of patency of the spinal cord. It must be said that this is not always possible.
- Elimination of visceral-vegetative disorders.
Recovery may take a long time - a year or more.
In case of a crack in the cervical spine, one-stage traction of the spine and subsequent wearing of the Shants collar is prescribed, which ensures the immobility of the damaged area. In some cases, a doctor may recommend the use of a Glisson loop to help prevent spinal cord injury.
Medicines given to the patient:
- "Riboxin";
- "Methyluracil";
- ATP preparations;
- vitamins;
- "Osteomed";
- "Chondrolon".
If conservative treatment is not possible, surgery is scheduled.
When a crack in the thoracic spine develops complications in relation to the gastrointestinal tract, therefore, in addition to stretching the spine and taking medication, drugs are prescribed that normalize intestinal motility.
In case of injuries of the sacro-lumbar department, the patient takes drugs that will prevent the development of complications in the functionality of the rectum and bladder. Stretching of the spine is prescribed. The lumbar region must also be immobilized. For this purpose, the patient must wear a lumbar brace.
Compression fracture of the spine in the elderly
Violation of the functionality of the spine is observed after 50 years. At this age, the production of intervertebral fluid decreases, as a result of which the vertebrae become less mobile.
In the elderly, a compression fracture of the spine may be due to the following reasons:
- osteoporosis - loss of calcium, which leads to a violation of the density of the vertebrae;
- dysfunction of the ligamentous apparatus of the vertebrae;
- injuries.
Half of the cases are diagnosed with a compression fracture of the spine due to osteoporosis.
Symptoms:
- spine pain;
- pain in the lower extremities.
Conservative treatment of spinal fissures in old age is:
- taking non-steroidal anti-inflammatory drugs - Diclofenac, Ibuprofen, Movalis, Dexalgin;
- exclusion of overloads when walking and physical work;
- wearing corsets;
- taking calcium and vitamins.
Surgical intervention in the elderly is usually not performed, since recovery after surgery is difficult, and complications from the cardiovascular system are also possible.
Compression fracture in children
As for the compression fracture of the spine in children, it is accompanied by a sharp pain that can radiate to the upper and lower extremities. In case of chest injurythe child may experience small and short-term interruptions in breathing, and the skin may become bluish.
In some cases, a compression fracture of the spine in a child is not accompanied by a bright clinic, but proceeds against the background of general weakness of the body and background pain syndrome.
Diagnosis is carried out in two stages.
First:
- gathering anamnesis;
- the doctor runs his fingers along the spine and marks the area of particular pain;
- muscle strength tests, sensitivity tests, tendon reflexes and so on.
Then assigned:
- x-ray;
- CT, MRI;
- additional studies - densitometry, assessment of the spinal cord and more.
Treatment of spinal fissures in a child is not much different from the treatment of a similar pathology in adults. It is necessary to unload the back, as well as protect the vertebrae from additional deformation and pinching of the spinal cord.
In case of complex injuries, as a result of which direct pressure is exerted on the nerve roots and spinal cord, surgical intervention is required - the damaged vertebrae are restored or removed. The following techniques are then used to stabilize the spinal structure:
- Vertebroplasty - medical cement is inserted with a biopsy needle. The damaged vertebra is fixed and stabilized.
- Kyphoplasty - the introduction of an air balloon into the intervertebral bones, it restores the normal height of the vertebrae. Then pouredbone cement that fixes the vertebrae. The entire damaged area is fixed with titanium plates.
The entire period of treatment, the child must be at rest and observe bed rest. The patient's bed should be hard, and the head should be raised by 30 degrees. To take a vertical position, it is necessary to wear a reclining corset.
In the recovery period, a course of exercise therapy, physiotherapy, spa treatment, swimming, balneological procedures are prescribed.
It is important to understand that the concept of a “fissure in the spine” is very different from the concept of a “fissure in the radius”. In the second case, it is really better than a fracture, and treatment and rehabilitation are many times faster. In some cases, with a crack in the bone, even gypsum is not necessary - a tight bandage is enough. A crack in the spine is a completely different matter. It is necessary to be aware of the danger of this condition, consult a doctor in a timely manner, and also disciplinedly go through all stages of treatment. Negligent attitude to this pathology can result in very serious and irreversible consequences.
