Fracture of the spine. Treatment of vertebral fracture. First aid, surgery, rehabilitation

Despite its strength, the human musculoskeletal system is often subjected to high loads, which can result in injuries. The most serious and serious damage is a fracture of the spine. Treatment of the vertebral fracture will directly depend on the severity of the injury and the location of the localization. With such damage, neighboring tissues are often involved in the process, for example, muscles, spinal cord, ligaments. This can already threaten more serious problems.

We will try to deal with different types of vertebral fractures, first aid and treatment of this trauma.

Varieties of fractures of the spine

Fractures of the spine are of different types and degrees. The classification of fractures is done by some features. If we take into account the mechanism of damage, we can distinguish three types of injury:

1. Compression fracture. Occurs as a result of squeezing the vertebrae under the influence of traumatic force. Often such a damage ends up falling on the back, legs or buttocks.
2. Flexion-extensively damaged, or they are also called flexion-extensor lesions. Such a trauma is considered to be the heaviest, based on the flexion and extension of the spine as a result of an accident or the falling of heavy objects on the back.
3. Rotational injuries. Their essence lies in the transverse movements of the spine around the longitudinal axis. This happens because of a direct blow.

Compression fracture, in turn, is divided into several degrees:

• The 1st degree differs by a decrease in the height of the vertebrae by less than 50%.
• 2nd degree - the height is reduced by half.
• At 3 degrees the height of the vertebrae is reduced by more than 50%.

If at a fracture of the spine only one vertebra is damaged, then such a trauma is called a single fracture. With multiple lesions, the integrity of several vertebrae is affected.

When considering the localization of trauma, we can distinguish the following types of fractures:

1. Fracture of cervical department.
2. Fracture of the thoracic spine.
3. Damage to lumbar vertebrae.

In addition to these types, you can still select several:

• Stable fracture. With such damage, the vertebrae do not move, adjacent tissues are not damaged.
• Unstable damage. In this case, the vertebrae are displaced, may be fractured.

If we consider the deformation of the vertebrae, the fracture can be classified as follows:

• Cuneiform fracture. Trauma has the form of a wedge facing the tip forward, and the base toward the spinal cord.
• Fragmentary. Such damage can be explosive when the fragments of the vertebral body are displaced in different directions, and can also be in the form of a drooping drop. Such fractures are unstable, most often you have to resort to surgery.

Symptomatic of vertebral fracture

In order for the consequences of the fracture to be as serious as possible, it must be diagnosed in time, provided with the correct first aid and transported to the hospital. Symptoms of fracture can be many, but the most significant and obvious are the following:

1. Strong pain in the area of injury. The pain usually becomes stronger when you try to change the position of the body or make movement with your hand or foot.
2. Restriction of movements. Since the fracture of the spine violates the anatomical integrity, then all attempts to complete the movement result in pain.
3. With a strong fracture, one can observe a deformation of that department, which is damaged.

Do not move the victim if there is a suspicion of a fracture of the spine. Treatment of the vertebral fracture and its success largely depend on the first aid provided and the complexity of the trauma.

Causes of fractures

Any fracture occurs as a result of exceeding the force of impact over the strength of bone formations. In order for a vertebral column to break, the following conditions must be met:

• Great impact force.
• Weak bone system.

Usually fractures of the spine occur due to a fall from height, as a result of increased exercise or professional and domestic activities. There is a high probability of obtaining such a fracture as a result of a traffic accident.

There are situations when bone tissue becomes fragile as a result of pathological processes in the body. In this case, even small impacts can lead to such a trauma. This can happen if there are the following diseases:

• Osteoporosis.
• Presence of tumors.
• Tuberculosis.
• Disorders in the endocrine system.

Whatever the reason, the first aid for a fracture of the spine should be provided competently, so as not to lead to even more serious consequences.

Diagnosis of a fracture

The pain that occurs during a fracture is not a specific sign of such a trauma, therefore, in order to make an accurate diagnosis, the following examination is necessary:

1. Make a radiograph of the spine. This will require a direct and lateral projection to detect the exact location of the lesion and determine the severity of the injury.
2. Computer tomography is usually prescribed after radiography in order to view the area of damage as closely as possible.
3. Myelography will show the state of the spinal cord after a fracture.
4. An examination by a neurologist is necessary to check the sensitivity and functionality of nerve endings and spinal cord.
5. An MRI doctor can appoint if there is a suspicion of damage to the structures of the spine.
6. Densitometry is performed in rare cases to exclude osteoporosis.

After all the research, the doctor will be able to accurately diagnose, determine the complexity of the fracture, assess its danger and choose the right treatment tactics.

Fracture of cervical spine

The cervical region is the initial link in the spinal column. It contains seven vertebrae. Quite often, as a result of a fall on the head, there is a fracture of the first vertebra, which is called the atlant.

The danger of such a fracture is that it can damage not only the spinal cord, but also some parts of the brain. For example, if the medulla oblongata is damaged, it is fraught with a violation of breathing and palpitation.

It is more difficult to detect a fracture of the second cervical vertebra , the patient usually complains of pain while rotating his head. Depending on the degree of fracture, such trauma can lead to neurological problems or to severe damage to the spinal cord, which is incompatible with life.

Damage to the remaining cervical vertebrae, as a rule, occurs as a result of sharp bending of the neck. If the injury affects the ligaments, there is a risk of damage to the spinal cord.

Fracture of the lumbar spine

The most common types of vertebral column damage are compression fractures of the thoracic and lumbar vertebrae. This most often occurs as a result of falling on the buttocks or jumping from a high altitude.

If there is a disease of osteoporosis, the lumbar fracture of the spine can occur and as a result of a slight fall. The danger is that at the same time not everyone turns to the doctor, taking back pain for the symptoms of age-related changes.

Emergency assistance

If you suspect a fracture of the spine, you need to properly help the victim. Without visiting the hospital in this case can not do, so you need to correctly transport.

First aid will be as follows:

1. Lay neatly the injured on the back on any hard surface: it can be a door, shield, plywood or any other improvised material.
2. Lock your legs and torso.
3. If the pain in the cervical region, then it must be immobilized.
4. If the vertebrae fracture in the thoracic or lumbar region, place a soft cushion under the injury site.
5. After giving the patient a motionless state, you can give an analgesic to relieve pain.
6. You can not transport the patient in a sitting position.

Correctly rendered first aid can save the victim life.

Forbidden for suspected fracture of the spine

Such a trauma is quite serious, therefore there are some actions that are categorically contraindicated:

• You can not force the victim to sit or stand on his feet.
• It is forbidden to try to independently place the vertebrae in place.
• It is not recommended to give drugs if the victim loses consciousness or the swallowing function is impaired.
• Do not pull hands or feet or try to transfer the victim to yourself.

Any of these actions can lead to serious complications, so do not risk your health if there is a fracture of the spine.

Treatment of vertebral fracture

Without therapy in a medical institution, in the presence of such an injury is indispensable. Only a competent specialist will be able to prescribe an adequate treatment that will avoid all complications.

Treatment can be conducted in two ways:

1. Conservative.
2. Surgical.

Which group should be used to deal with the fracture as effectively as possible depends on the severity of the trauma and its localization.

Conservative treatment

Usually a full course of fracture therapy takes about 3 months, it is under constant monitoring by a doctor and regular examination to identify the process of splicing damaged vertebrae.

Fracture therapy includes the following steps:

1. Getting rid of the pain. Such a trauma causes severe pain, so the patient needs to give painkillers, they will not affect the speed of recovery, and the condition will improve.
2. Restriction of activity. To accelerate the process of vertebral fusion, it is necessary to limit as much as possible any mobility. You can not perform actions that increase the load on the spine, less sit and stand. Without this rule, the speed of adhesion will decrease.
3. Fixation. After a fracture of the spine, many complications of a neurological nature may occur. To avoid them, it is necessary to fix the spinal column in one position. For these purposes, you can use a corset with a fracture of the spine. Verteblobism is a procedure by which you can restore the integrity of the spine. It is used in case of compression fracture in many clinics. The essence is as follows: a puncture is made in the skin and a metal rod is inserted into the body of the vertebra, through which the cavity is filled with a solution to strengthen the structure of the vertebra. This procedure is performed under local anesthesia.
4. Kyphoplasty is used to restore the height of the vertebra. The doctor makes incisions on the skin and inserts a balloon into the body of the vertebra, which is inflated to the desired height to restore the size of the vertebra. Then cement is cemented, firmly fixing the position.

Surgery

Unfortunately, it is not always possible to cope with such traumas with conservative methods. If a vertebral fracture is diagnosed, surgery may be required if there is a risk of neurological complications.

During surgical intervention, the surgeon resection of those parts of the vertebra, which traumatize the nerve roots and spinal cord, and in their place are put metal implants.

Complications of the operation

Even considering that modern equipment has great capabilities, and surgeons - the experience of such operations, such intervention is potentially dangerous, as in proximity the spinal cord and nerve endings are located.

As a result of treatment of a compression fracture, the following complications may occur:

1. Kyphotic deformation. This is the appearance of a hump in the thoracic region of the spine. This complication is common in elderly patients. The patient is often tormented by pain, there may be problems in the work of the cardiovascular system, the gastrointestinal tract, or the lungs. Fatigue comes quickly, dyspnea appears.
2. Segmental instability occurs most often in the event that as a result of fracture, the height of the vertebra decreased by more than 30%. With such a complication, pain not only appears at rest and during movement, but degenerative-dystrophic processes in the spine begin.
3. Bone fragments, formed during complex fractures, can lead to neurologic complications. They can appear immediately or after a while. Symptoms of such disorders are pain during movement and at rest, as well as a decrease or total loss of sensitivity and numbness of the limbs.

The more time passed from the moment of fracture to the beginning of treatment, the greater the risk of various complications.

Consequences of fractures

Exact prediction is difficult to give if there is a fracture of the spine. The consequences can be quite deplorable. Some victims do not reach the hospital and die from spinal shock, this occurs as a result of damage or rupture of the spinal cord.

If the spinal cord is injured, there is a risk of paralysis. Patients may lose their ability to move independently for a long time or for the rest of their lives.

If a simple fracture of the spine, the consequences can be in the form of osteochondrosis or intervertebral hernia. To avoid such consequences or minimize them, it is necessary to control their treatment, to comply with all the recommendations of doctors, especially during the rehabilitation period.

Rehabilitation after a fracture of the spine

It is not always possible to avoid injuries: an accident, an accident - and here's a fracture of the spine. Treatment of a vertebral fracture must necessarily end with a rehabilitation period. The goal of this important stage is the restoration of injured vertebrae and the return of the former mobile way of life.

For these purposes, doctors resort to the following methods:

• Physiotherapy.
• Electrostimulation.
• Massage.
• Cold therapy.
• Physiotherapy.

Only an integrated approach can completely defeat the fracture of the spine, rehabilitation will accelerate the process of recovery, prevent complications and return mobility.