Compression fracture is a fairly common pathology, which is characterized by damage to the vertebrae in any part of the spine. At the same time, their bodies are not destroyed, but squeezed, taking a wedge-shaped shape. More often, pathology appears in children, as well as in the elderly. In the first case, excessive activity becomes the cause, and in the second, dystrophic processes in the tissues of the skeleton.
Reasons for appearance
Compression fracture of the vertebral body occurs due to the following reasons:
- Injury that occurred due to intense vertical load on the spine. This leads to a jump from a great height on straight legs, a sharp slope, falling to the ground.
- Injury due to car accident.
- Weakness of bone structures caused by osteoporosis. At the same time, tissues cannot withstand intense loads and are damaged from minor movement.
- Compression fracture is provoked by metastases that have spread to the spine. They destroy bonesfabrics.
- Problems with metabolic processes, dysplasia, and other diseases that make skeletal structures fragile.
- Direct blow to the lumbar, chest, neck.
- Sports injuries.
- Infectious diseases of the bones (tuberculosis).
- Osteochondrosis. As a result of this disease, the destruction of skeletal structures, cartilage occurs. The connection of the vertebrae becomes unstable.
The risk group includes patients over 60 years of age, people with a genetic predisposition to tissue fragility. Children can also be included here, since the norm of life for them is high physical activity.
Symptoms of pathology
Compression fracture is characterized by vivid manifestations. The following symptoms of the disease can be distinguished:
- Sharp pain that can radiate to other parts of the body, but subsides at rest. Discomfort worsens with coughing and movement.
- Headache.
- Nausea and vomiting.
- Loss of sensation in limbs.
- Slight swelling at the injury site.
- Segmental spinal instability.
- Asthenia, a general weakness that only increases with time.
- Impaired mobility.
- Possible redness of the skin, the appearance of bruising at the site of injury.
- Spinal deformity.
If the injury is open, the patient may bleed heavily. A compression fracture of the thoracic spine is characterized bydifficulty breathing.
Disease classification
Compression fracture of a vertebra can be classified according to several parameters:
- According to the degree of development of pathology. Only three stages can be distinguished here: the first (the height of the vertebra decreases by less than 1/3 of the original size); the second (reduction occurs by half); the third (indicator more than 50%). The last degree is a very serious condition in which fragments of bone tissue appear.
- According to the consequences of damage: uncomplicated or complicated fracture. In the first case, the pain is not strong and passes quickly. If there are complications, then the victim has neurological symptoms.
- According to the location: damage to the neck, compression fracture of the thoracic spine, lumbar injury.
- By extent of damage: isolated, multiple, involving the spinal cord (or not).
It is also possible to distinguish penetrating or non-penetrating compression fracture. In the first case, the intervertebral discs and endplates are damaged. In non-penetrating trauma, there are no such lesions.
Diagnostic features
Compression fracture can be recognized by carefully examining the patient. To do this, contact a traumatologist.
Diagnosis includes the following procedures:
- X-ray. It is carried out in lateral and direct projection. The procedure must be carried out throughout the entire period of treatment andrehabilitation.
- Neurological examination. Thanks to him, you can determine the degree of damage to the nerve roots.
- MRI. Here the fabrics can be seen in layers. You can not only detect the localization of damage, but also see the state of the vertebrae in great detail.
- Myelography. It is necessary for complicated fractures, if the fragments damaged the spinal cord.
- Densitometry. This procedure allows you to detect osteoporosis in the early stages of development.
In addition to a visit to a traumatologist, the patient needs to visit an endocrinologist (especially for young people).
First Aid
Compression fracture of a vertebra is a complex disease that requires increased attention from others. The patient must be given first aid and call the doctors. To begin with, the victim should be laid on a hard surface.
If a compression fracture of the lumbar spine occurs, then a roller should be placed under this area. If the coccyx is damaged, the patient should be placed on the stomach. A fracture of the neck requires immediate fixation of this part with the help of the Shants collar.
In case of damage to the thoracic region, the patient must also be laid on his stomach, and a roller should be adjusted under the damaged area. Also, before the arrival of doctors, you need to control the heartbeat, monitor the reaction of the pupils. If there is bleeding, a tight bandage will be required.
If an ambulance is not able to leave quickly, then a person can be taken to the hospital on their own. But this must be done very carefully. Anypatient movements are minimized. Sit down or stand up is not worth trying. Otherwise, there is a risk of displacement of bone fragments. You need to take a person to the hospital on an absolutely flat and hard surface.
Traditional and surgical treatment
Treatment of a compression fracture requires a long time, an integrated approach and self-discipline of the patient. Conservative therapy involves the use of drugs that relieve pain and prevent the development of the inflammatory process. Medicines are prescribed in the form of tablets and injections.
NSAIDs ("Ketorolac", "Nimesulide"), chondroprotectors are prescribed for a person. In case of a compression fracture of the thoracic region or any other part of the spine, its fixation is required, the physical activity of a person is limited. It is important to strictly observe bed rest. Every month, an x-ray diagnosis of the patient is required.
After 1, 5-2 months after the start of therapy, physiotherapeutic procedures are included in the scheme: UHF, heating with ultraviolet rays, electrophoresis. Orthopedic devices are used to fix the damaged section. In severe cases, treatment involves surgery. There are these types of interventions:
- Kyphoplasty. Special chambers are inserted into the vertebral body, which are then filled with a special fixative.
- Vertebroplasty. To eliminate the problem, a special substance is injected into the vertebral body that cements it. This strengthens the bone structure. This operationminimally invasive, therefore, it allows you to quickly achieve the desired effect and reduce recovery time.
- Resection of structures followed by implant placement. Such an operation is necessary if the patient has spinal instability with a risk of damage to blood vessels, nerve roots, and the spinal cord.
Any operation can give neurological complications, lead to subsequent deformation of the spinal column. Therefore, it should be carried out by a highly qualified specialist.
Features of childhood injuries
Compression fracture of the spine in children is more often localized in the middle of the thoracic region. Diagnosing the disease on the very first day of injury is difficult, since not all children immediately talk about the problem. They can damage several adjacent vertebrae at the same time.
Treatment of a compression fracture in children is performed with the help of a one-time restoration of the position of bone structures, followed by fixation of the damaged section with a plaster corset. Spinal traction may also be prescribed to prevent skeletal deformity.
After a while, the child is prescribed physical therapy, which allows to strengthen the muscles, restore the former mobility of the body. Also, the victim is prescribed an optimal daily regimen, good nutrition. If you follow the recommendations of doctors, rehabilitation will be faster.
TherapeuticPE
Treatment of a compression fracture of the spine is performed not only with the help of medicines and surgical methods. Therapeutic exercise helps to speed up tissue repair, improve mobility, and prevent the development of complications.
The following exercises will be useful:
| Body position | Type of exercise |
| Lying on your back |
|
| Lying on stomach |
|
First you need to start with a few very simple exercises. The load is increased gradually with the permission of the doctor. After such a fracture, sports are not prohibited. But don't run or ride a bike. It is better to give preference to swimming.
Breathing exercises will improve the effect of exercises. As the recovery progresses, the area of development expands. The maximum duration of the complex is 45 minutes, but the time must be increased gradually.
Fracture recovery
The average recovery time after a compression fracture is 6 months. The rehabilitation period begins almost immediately after the necessary conservative and surgical procedures. In the first 10 days, all methods of patient recovery do not involve changes in his body or mobility. Depending on the severity of the injury, active load may be added from the 2nd-5th week.
The rehabilitation process involves the use of the following methods:
- Physiotherapy treatments. They contribute to the restoration of microcirculation in the affected tissues, regeneration of the vertebrae. Electrophoresis, UHF, treatment of affected areas with ultrasound, heating with ultraviolet rays, cryotherapy, electrical stimulation, paraffin therapy will be useful.
- Therapeutic exercise. Exercises are aimed at restoring the patient's mobility, strengthening muscle tissue. Additionally, the functionality of the cardiovascular system and lungs improves.
- Massage.
If a person needed surgery, then he will need postoperative rehabilitation. It is carried out strictly under the supervision of a doctor and begins on the second day after the procedure.
During the rehabilitation period, it is important to follow a diet that promotes the restoration of skeletal tissues. The menu should include foods rich in calcium, phosphorus, vitamins B and C.
You can sit down after such an injury no earlier than a month later. It all depends on how quickly the body recovers. At the same time, after completion of rehabilitation, a personyou will have to use orthopedic devices for some time. Work in a static position, strongly bend down or lift heavy objects is prohibited.
Possible complications and fracture prevention
Compression fracture of the thoracic vertebrae or damage to other parts of the skeleton is fraught with serious complications:
- Spinal stenosis.
- Disorders of the functionality of the nervous system.
- Spinal deformity.
- Osteochondrosis.
- Sciatica.
- Paresis and paralysis of limbs.
- Compression myelopathy requiring surgery.
To avoid such a problem, the following preventive measures must be followed:
- Should do sports to strengthen the muscular corset. It is better to give preference to swimming in the pool, dancing or fitness.
- Try not to lift heavy things.
- Eat foods rich in minerals and vitamins involved in the construction of the skeleton.
- Give up bad habits, exclude fatty and smoked foods.
- Avoid spinal injury, high jumps, falls.
- Take frequent walks in the fresh air to improve blood circulation in the body.
- During heavy physical work, use orthopedic devices to reduce the load on the spine.
Compression fracture is not an easy pathology. Although it does not always lead to damage to the spinalbrain and disability, such an injury requires treatment and rehabilitation. Otherwise, complications may develop that will make the person immobile.
