Compression fracture of the spine is an injury accompanied by compression of the vertebrae as a result of external forces of compression and flexion. The bone structures crack and are somewhat compressed, mainly in the anterior sections, while the vertebrae acquires a wedge-shaped shape.
If a person suffers from osteoporosis, then bone density is significantly reduced, and compression can occur even with minimal stress. It is worth noting that a fracture is not always detected on time, which is why various kinds of dangerous consequences can occur.
Feature of injury
At the moment of injury, a protective reaction occurs, namely: the muscles of the press and flexors of the chest contract. However, there is a slight tilt of the upper limbs forward. This puts high pressure on the vertebrae.
The main feature of a compression fracture of the spine is the stability of mechanical or neurologicaldamage. This injury may affect the upper lumbar and lower thoracic regions.
Classification and degree
There are 3 degrees of compression fracture of the spine:
- At grade 1, there is a decrease in the vertebra by less than 50%.
- With the 2nd - by 50%.
- At grade 3, the vertebra is compressed by 51% or more.
By the nature of the course, such an injury can be complicated and uncomplicated. The first type is characterized by the presence of various kinds of neurological disorders.
The most dangerous is a comminuted fracture, as there is a high risk of damage to nerve endings by bone fragments. Such damage may take some time to show up.
In case of damage to the thoracic region (in this type of compression fracture of the spine according to ICD-10 code S22), such an injury may not initially bother the victim, causing only minor inconvenience. The consequences of an untimely visit to the doctor may be osteochondrosis or sciatica.
By appearance, such injuries are divided into the following types:
- wedge;
- fragmentation;
- compression-tear-off.
The wedge-shaped type is characterized by the fact that the vertebral body is flattened on one side. Its wide part is directed towards the central part, and its narrow part towards the sternum.
Compression-avulsion fractures are accompanied by a detachment of part of the vertebra. You can determine it on an x-ray.
Shrapnel type of injury is characterized by the fact that the vertebra is compressed and somewhatexpands, splitting into several parts.
Causes of occurrence
Often, a compression fracture of the spine is a consequence of a jump from a significant height with a landing on straight legs or on the buttocks. Such damage can be caused by injuries at work, as well as car accidents. Other reasons include:
- occurrence of osteoporosis;
- metastases;
- any disease accompanied by an increase in bone fragility;
- violation of metabolic processes.
In older women, this kind of injury is often observed, which occurs when the hormonal background changes.
Main symptoms
There are common signs of a compression fracture of the spine:
- painful sensations of varying severity;
- general weakness and dizziness;
- back pain when moving.
In itself, the main cause of injury is already a characteristic feature. A compression fracture of the thoracic spine is accompanied by difficulty breathing, up to its complete stop. In some cases, pain may radiate to the abdomen or other area. Painful sensations decrease in a horizontal position, and intensify when trying to move or in a standing position. There is tension in the back muscles, especially in the affected area.
When a compression fracture of the lumbar spine is characterized by the occurrence of involuntary urination. Additionally, the patient may complain of nausea, vomiting, severe headache, dizziness. Depending on the area of damage, sensory and motor impairments are possible.
If the fracture was caused not by trauma, but by osteoporosis, then the pain increases gradually. Initially, the patient does not pay any attention to discomfort and turns to a specialist only with the development of neurological disorders.
Diagnostics
Continuous back pain is the main symptom of a compression fracture. However, this is a non-specific symptom, and that is why it is imperative to conduct a comprehensive diagnosis, which includes:
- x-ray;
- tomography;
- myelography;
- densitometry.
It is the correctness of the diagnostic measures and the determination of the severity that determines what treatment will be carried out and how long it will take to recover.
Features of treatment
When the first signs of a compression fracture occur, you should immediately call an ambulance. Before the arrival of the doctor, the victim must be laid on a flat and hard surface. To do this, you can use improvised means. If you suspect damage to the vertebrae of the cervical region, you should try to fix this area as much as possible. In case of a fracture of the lumbar or thoracic vertebrae, you need to put a roller under the damaged area.
Treatment measures should be directed to:
- eliminate pain;
- limitation of physical activity;
- fixing the damaged area.
To eliminate pain, the doctor will recommend the use of anti-inflammatory drugs, in particular, such as Nimesulide, Aceclofenac, Ketoprofen. At the recovery stage, it is recommended to additionally connect drugs that help accelerate the recovery of affected tissues, such as calcium supplements and Chondroitin.
The activity of the victim should be minimized, heavy lifting should be excluded, as well as prolonged sitting and standing. For people over 50, prolonged bed rest is recommended due to the presence of osteoporotic changes in the body.
In addition, the doctor recommends wearing a corset for a compression fracture of the spine, as it allows you to unload the affected area and helps create favorable conditions for the restoration of the affected department.
The average full recovery period is approximately 3-4 months. X-ray control should be carried out monthly. Physiotherapy is prescribed after 1.5-2 months from the start of therapy. Recovery from an injury occurs after 6 months.
Treatment of a fracture in children
Compression fracture of the spine in an infant has its own specific features. Most often, their lesion is localized in the mid-thoracic region. Basically, several adjacent vertebrae are injured simultaneously, andsometimes there are 1-2 intact vertebrae between two broken vertebrae.
Diagnosis in this case is quite difficult, which is why most young patients do not undergo the required examination on the day of injury. Children are characterized by damage to both cartilage plates. In this regard, their treatment has its own specific characteristics. These include:
- application of one-stage reposition;
- gradual reduction;
- functional technique.
After a while, the child is assigned to wear a plaster corset. With a compression fracture of the spine, the functional technique consists in unloading traction of the latter. Thanks to this, it is possible to prevent subsequent deformation of the spinal column. And as an additional technique, therapeutic gymnastics is prescribed, which helps to strengthen muscles and contributes to the formation of a muscular corset.
Operating
Treatment of a compression fracture of the lumbar spine is mainly performed by surgical intervention to restore the normal height of the vertebrae. For this, kyphoplasty and vertebroplasty are used. During kyphoplasty, the doctor corrects the shape and location of the vertebra, fixing it with cement.
Vertebroplasty is characterized by the fact that special bone cement is injected into the vertebral body. As a result, its shape is restored. All interventions are performed in a minimally invasive way - through small incisions, with the help ofendoscope.
In case of a complicated compression fracture of the thoracic spine, the treatment is carried out using an open operation. The neurosurgeon performs decompression, that is, removes areas of the vertebra that put pressure on the nerve endings and the back of the brain. After that, the affected area is fixed by using special metal structures.
Other Therapies
Functional treatment of a compression fracture of the thoracic spine is divided into inpatient, requiring hospitalization of the patient, and outpatient. In addition to traction, massage, physiotherapy and exercise therapy are also used.
Due to the negative impact of bed rest on bone structure, early activation of patients is recommended. Physiotherapy procedures include:
- electrophoresis;
- electrostimulation;
- magnetic therapy;
- paraffin applications.
You can strengthen the muscular frame with the help of massage. Thanks to its regular implementation, you can normalize blood circulation and metabolism. Consideration should be given to the risk of injury, which lies in the fact that a person may remain disabled for life.
During the treatment, it is imperative to follow a special diet. The diet must contain foods rich in magnesium and calcium. It is necessary to exclude alcoholic drinks, strong tea and coffee, as well as fatty foods.
The goal of exercise therapy for a compression fracture of the spine is to normalizepsycho-emotional state of the patient and an increase in the tone of the body. Exercises are prescribed after the acute period. The patient must always be under the strict supervision of a specialist and be extremely careful not to provoke an exacerbation. Therapeutic exercise consists of breathing exercises, which are combined with elementary exercises.
Rehabilitation
After a compression fracture of the spine, rehabilitation is mandatory. It is required to restore the functionality of the affected area. When carrying out rehabilitation measures, it is necessary to perform physiotherapy once every six months. For this, paraffin and electrophoresis are often used, and in some cases, radiotherapy. It is useful to combine such procedures with massage.
For sleep, you need to use only orthopedic mattresses, and under the neck, as prescribed by the doctor, put a hard roller.
What is dangerous injury
The consequences of a compression fracture of the spine can be quite dangerous. They are:
- occurrence of post-traumatic osteochondrosis with hernia and protrusion;
- development of kyphoscoliosis;
- instability of the affected segment;
- development of paralysis.
It is worth noting that the consequences may occur immediately or proceed gradually. Bone fragments lead to a narrowing of the spinal canal, where the spinal cord is located. As a result, numbness of the limbs, malnutrition and muscle weakness are observed.
Instabilityspine
Among the unpleasant consequences of a compression fracture of the spine, it is necessary to note the instability of the affected area. This leads to the fact that a person often cannot perform even the simplest household work. In addition, there is an occurrence and a significant increase in pain, as well as degenerative changes in the damaged segment. Often there is damage to the spinal cord and its roots.
Kyphotic deformity
One of the unpleasant consequences of the described violation occurring in the thoracic region is kyphotic deformity. It often occurs in the elderly, but in some cases it can also occur in younger patients.
With severe kyphosis, in addition to a violation of posture, there may be a certain limitation of movements in the spine. There is also a deterioration in the functioning of the cardiovascular and respiratory systems, and sometimes there may be neurological disorders. A change in the normal shape of the spine can lead to an overstrain of its individual parts, which provokes the formation of muscle spasm and the formation of chronic pain.
Problems of a different nature
In addition to the above problems, due to prolonged lying in the process of treating an injury, the patient has negative processes in the lungs and intestines. These include a tendency to gas formation, indigestion and constipation. Phlegm can accumulate in the lungs, which threatens the development of bronchitis and pneumonia.
One of the worst consequences of the namedA fracture is a crushing or tearing of the roots of the spinal cord. Injury causes damage to the nerve endings. If compression occurred in a long-term period, then neurological disorders are due to squeezing of blood vessels and deterioration in the nutrition of the spinal cord.
Among the frequent consequences of a neurological nature, the following should be highlighted:
- numbness;
- feeling cold;
- pain after exercise.
When crushing nerve endings, which occurs with a severe fracture of the spine, irreversible paralysis of the limbs can occur. In children with a complicated type of injury, the onset of paresis is possible, as well as impaired functioning of the pelvic organs, in particular defecation and urination. In addition, bedsores, osteochondrosis, and intervertebral hernia may occur.
The higher the spinal cord injury occurs, the greater the risk to the life of the patient, and the greater the likelihood of further disability. If the injury is very serious, then the victim may have bleeding and leakage of cerebrospinal fluid. In this case, infection and suppuration are simply inevitable.
After an injury, there is a high risk of a cyst or fistula.
