Spine injuries are very dangerous, as there is a high risk of spinal cord injury and various neurological complications. Even if it's a compression fracture. Such an injury is considered not very severe and, with timely treatment, its prognosis is favorable. Compression fractures are very common, especially in children and the elderly. Complications after it are rare, but the danger is that in the absence of severe pain, not all patients go to the doctor.
What is a compression fracture
The human spine is made up of individual vertebrae. This design allows it to be flexible and mobile, but withstand a large load. The body of each vertebra is a spongy bone tissue with a dense shell. The spinal canal runs through it. The vertebrae are small, between themelastic intervertebral discs. They perform a shock-absorbing function and protect the vertebrae from damage during shaking and jumping. But with a strong blow or fall, the vertebrae can be injured. The most common injury is a compression fracture.
Compression is hard pressure. Therefore, the so-called injury, in which the vertebra is squeezed in a vertical position. It doesn't break, it flattens. This happens especially strongly in its front part, so it takes on a wedge-shaped shape. But sometimes with a severe degree of damage, it may crack into small pieces. Usually, with a compression fracture, 1-2 vertebrae are damaged, sometimes more. At the same time, they decrease in size in height.
Reasons
Compression fracture can occur for a variety of reasons. Children, athletes, the elderly are subject to such trauma. Most often, damage can be received in such cases:
- a sharp blow to the back;
- falling from a height onto the back, buttocks or straight legs;
- hitting the head from above or diving into the water head first;
- jump from a height;
- non-compliance with safety regulations when playing sports;
- car accident.
In people with osteoporosis, a compression fracture is possible even with a slight jar, turning or tilting. Such lesions are considered pathological. They often occur in older women. If several vertebrae are damaged and treatment does not take place on time, a decrease in their height leads toto the appearance of a hump. The danger of pathological fractures is that they pass almost imperceptibly, as they do not cause severe pain.
Degrees of compression fracture of the spine
Usually presenting symptoms and effectiveness of recovery depend on the severity of the injury. Most often, with domestic injuries, the fracture is not strong. It may not even cause pain. But sometimes after a compression fracture, long-term treatment and rehabilitation is required. This happens if the blow was so strong that it led to serious damage to the vertebra.
According to these signs, there are three degrees of severity of injury. The prognosis of the patient's recovery depends on this.
- At grade 1 compression fracture, the vertebrae can flatten to a third of the height. Such an injury is easily treated and rarely leads to complications.
- 2 degree is characterized by the fact that the vertebra is halved. Bone tissue can be damaged and compress the spinal cord. This can lead to neurological complications.
- 3 degree is considered a very severe injury, as the vertebra is reduced by more than half. In this case, only surgical treatment is possible, in addition, serious complications most often occur.
How trauma manifests
Compression fracture is a very common injury, quite common in children. The effectiveness of recovery depends on how correctly and on time the treatment will be carried out. Often, after this injury, the mobility of a person is not impaired, the pain may also not be very strong. Therefore, everyone should know how a compression fracture of a vertebra manifests itself. Usually, after such an injury, the following symptoms appear:
- back pain in the area of the damaged vertebra;
- limited limb mobility, muscle weakness;
- increased pain when changing position, coughing, sneezing, sitting or standing;
- local swelling and redness;
- back spasm;
- pain on palpation of the spine.
If the injury is severe enough to damage nerve endings, neurological complications may occur. They manifest as numbness or tingling in the limbs, nausea, vomiting, headaches. With an injury in the thoracic region, breathing problems, abdominal pain are possible, if a vertebra in the lumbar region is damaged, there is a risk of disruption of the pelvic organs.
Features of a thoracic fracture
This part of the spine is the least mobile, so it is less likely to be subjected to various pathologies. The vertebrae here are protected from all sides and are rarely displaced. But a compression fracture of the thoracic region is common, especially in its lower part. It can be after a fall, a jump from a height, a strong blow to the back.
The danger of this type of injury is that damage to the vertebrae in this department rarely manifests itself as severe pain. Therefore, many patients do not go to the doctor, but wait out the consequences of the injury at home. some victims do not notice at all that they have received a compression fracture. The danger of this is thatif you continue to load the damaged vertebra, it will gradually collapse, which after a while will lead to serious complications.
Fracture of the lumbar spine
This is a fairly common injury due to the high mobility of this part of the spine. A compression fracture can happen when you fall on your buttocks, after a strong blow to your back, or when you turn sharply. This happens with improper lifting of weights, playing sports, with a car accident. People with osteoporosis or curvature of the spine are most susceptible to such injuries.
Treatment of a compression fracture of the lumbar spine must take place in a medical facility. In this place, complications often occur with improper therapy and the absence of immobilization after an injury.
Cervical Fracture
Compression fracture in this place is rare, usually after a blow to the head from above or jumping into the water. Such an injury is also possible in a car accident. Damage to the vertebrae of the cervical region is the most dangerous, since here in the spinal canal there are many nerve roots and blood vessels that feed the brain. A serious compression fracture of a vertebra in the cervical region can lead to loss of mobility and sensation in the limbs or even the entire body.
The symptoms of this injury are a sharp severe pain in the neck, numbness and weakness in the upper limbs, swelling and redness at the site of the damaged vertebra. Headaches may begin, dizziness will appear,nausea.
Complications
With a mild degree of damage and timely treatment, the injury is usually cured easily. Rarely, neurological complications occur. Only if bone fragments compress nerves or blood vessels, numbness of the limbs, tingling, muscle weakness is possible. But most often, the soreness disappears in 1-2 weeks, and recovery occurs after 4-6 months.
But serious consequences of a compression fracture are also possible. Especially often this happens with untimely access to a doctor or with a severe degree of damage. Most often, instability of the vertebrae develops, their frequent displacement. This can lead to lumbago or sciatica, chest or neck pain. In addition, compression of the spinal roots can cause neurological complications.
A frequent complication of this injury is osteochondrosis, protrusion or herniation of the intervertebral discs, arthrosis of the intervertebral joints. A curvature of the spine develops, sometimes a hump appears.
Diagnosis
The main sign of injury is a decrease in pain when lying on a flat surface and an increase in pain when sitting or standing. But even a doctor cannot accurately determine by external signs that this is a compression fracture. A physical examination is required. An X-ray, CT or MRI is usually done. They help to detect the location of the injury, the number of injured vertebrae and the severity of the injury.
Very informative for the detection of a compression fracture radiography. It is done in two projections. ATlateral projection clearly shows a decrease in the height of the vertebra. An MRI or CT scan is only done to check for complications or to evaluate the condition of the spinal cord. Sometimes myelography is also done.
First Aid
To avoid complications and facilitate recovery, the actions of the injured person and those around him immediately after the injury are very important. First of all, you can not move, walk or sit. Be sure to lie on your back on a flat, hard surface. It is advisable not to transport the victim on your own, but to wait for the ambulance to arrive. After all, the stretcher must be rigid, a soft roller must be placed under the damaged spine.
If the coccyx is damaged or if there is no flat hard surface, it is recommended to lie on the stomach. In case of a fracture in the cervical region, it is necessary to fix it with a Shants collar. If the pain in the back is severe, ice should be applied to the site of the injury. You need to keep a cold compress for 10-15 minutes with breaks.
Features of treatment
This injury is treated in the trauma department of the hospital by an orthopedic traumatologist. The goal of therapy is not only to relieve pain, which is done by people who do not go to a doctor. It is imperative to reduce the axial load on the spine in order to prevent complications, as well as accelerate the restoration of the vertebral bone tissue. For this, conservative methods are most often used. Surgery after such an injury is required only in difficult cases, when the vertebra is reduced by more than half andneurological complications occur.
But usually the treatment of a compression fracture requires the use of conventional conservative therapies.
- Non-steroidal anti-inflammatory drugs are taken to relieve pain and swelling. Usually effective are "Nise", "Ketanov", "Movalis", "Diclofenac". If the pain syndrome is very strong, a paravertebral blockade with Novocaine is performed.
- To relieve the load from the vertebra, the patient should lie on a hard surface with the bed tilted towards the legs by 30°. A soft roller is placed under the damaged vertebra. It is also necessary to use soft loops through the armpits back with weighting. In case of a fracture of the cervical spine, traction is performed using the Glisson loop.
- Bed rest is needed for 1-2 months depending on the severity of the injury. Then the patient must wear a rigid corset or reclinator. It is forbidden to sit, stand for a long time.
- Physiotherapy methods are also used. They are prescribed a few days after the injury, when the pain subsides. These are magnetotherapy, laser treatment, UHF, electrophoresis, myostimulation, paraffin or ozocerite applications, balneotherapy.
Surgical treatment is used for grade 3 compression fractures. The operation is performed to restore the height of the vertebra. Usually do vertebroplasty or kyphoplasty with bone cement. These are minimally invasive surgeries. Open surgery is required only for complicated fractures involving the spinal cord orcompressed nerve roots.
Compression fracture: rehabilitation
After discharge from the hospital, the patient's performance is usually restored in 5-6 months. For some time, he is required to observe a non-strict bed rest, putting on a hard corset when he gets up. You can not sit and stand for a long time, especially when treating a compression fracture of the lumbar. Usually, with uncomplicated injuries, the functions of the spine are restored completely, especially in children and young people. But for this it is necessary to follow all the recommendations of the doctor. Recovery after a compression fracture can be lengthy, it necessarily includes wearing a corset, massage, and physiotherapy exercises. Effective spa treatment.
Exercise therapy is the main method of rehabilitation. First, while observing bed rest, breathing exercises are performed. Then they begin to bend their arms and legs. Actually therapeutic exercises are prescribed after the patient begins to walk. But at first they are still performed in the prone position. It can be lifting the body, legs, "bike", "scissors", "boat". Then the complex includes walking on all fours, swinging arms and legs. Such gymnastics strengthens muscles and corrects posture.
Be sure to also follow a special diet to ensure adequate intake of magnesium, calcium, zinc and vitamin D3. It is necessary to exclude all drinks that wash out calcium - coffee, soda, alcohol. It is important to avoid excessive physicalloads, do not lift weights, do not sit for a long time. But be sure to do special exercises twice a day. This regimen must be observed from 6 months to 2 years, depending on the severity of the damage.
