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Compression fracture of the spine

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Compression fracture of the spine

Compression fracture of the spine - this pathology is quite common among modern mankind and is caused primarily by car accidents, falls from a height and diving into a reservoir that is shallow for human growth, osteoporosis of bones, etc.

The mechanism of the formation of a compression fracture of the vertebral bodies with concomitant whiplash stretching of the muscles and ligaments of the cervical spine.

There are complicated and uncomplicated compression fractures of the spine. In the uncomplicated case of a compression fracture of the spine, the victim does not have any neurological symptoms, except for local pain or a feeling of discomfort in the acute period of the injury. When radiography in the case of a spinal fracture, a decrease in the height of the vertebral body is detected, it is possible to detect free fragments (fragments), the fracture line of the arch, or the spinous process of the vertebra.

These pains arise from the irritation of the nerve sensitive endings in the area of the compression fracture of the spine, during the disease, they will disappear until the patient fully recovers.

Compression fracture of the vertebral bodies of the cervical spine with compression of the spinal cord.

Compression fracture of the vertebral bodies of the cervical spine with compression of the spinal cord.

On the frontal section of the vertebral body, osteoporosis of the spongy substance of the bone is detected.

Such compression fractures of the spine often occur when falling from a small height or in elderly people with osteoporosis, when a small effort is enough for the vertebral body to flatten and decrease in height.

Often, such compression fractures of the spine with a decrease in the height of the vertebral body are not diagnosed immediately, since they do not cause many inconveniences to the patient himself, and are detected accidentally during X-ray examination for another reason.

Compression fracture of the thoracic vertebral body.

Compression fracture of the vertebral body.

 

Diagnosis of spinal compression fracture

Diagnosis of spinal compression fracture with a decrease in the height of the vertebral body begins with a neurological and orthopedic examination by a doctor. Based on the results of the consultation, the following additional diagnostic procedures may be prescribed:

  • radiography of the spine
  • CT scan of the spine
  • MRI of the spine - cervical, thoracic or lumbosacral region

The procedure for measuring bone density in cases of suspected bone osteoporosis is called densitometry. Densitometry, or measurement of bone density, is performed on special measuring equipment.

On the MRI of the cervical spine, a compression fracture of the vertebral body is visible, complicated by compression of the spinal cord (indicated by arrows).

A two-energy CT scan of the spine can lower the information from calcium, which makes it possible to distinguish between an old and a new compression fracture of the vertebra (in a patient with a history of small cell cancer of the right lung, it was possible to detect amplification of the signal at the site of bone marrow edema).

 

Complications of spinal compression fracture

Pressure sores are the consequences of a compression fracture of the spine with compression of the spinal cord. Bedsores occur as a result of prolonged lying on the back of the immobilized patient. Bedsores always require long-term treatment, because the neurotrophic function is impaired below the level of spinal cord injury, which greatly slows down the healing process in the areas of necrosis.

Complicated compression fractures of the spine with compression of the spinal cord are accompanied, in addition to local pain along with the site of the spinal fracture, by the presence of neurological disorders. These include motor and sensory disorders of the conducting and regulating functions of the spinal cord, which are particularly difficult cases that lead to the severe disability with the formation of non-healing bedsores and even the death of the patient.

Neurotrophic pressure sores are the consequences of a violation of innervation after a compression fracture of the spine with compression of the spinal cord.

 

Treatment of spinal compression fracture

Surgical treatment of compression fractures of the thoracic and lumbar vertebrae from Th5 to L5 with a decrease in the height of the vertebral body allows you to restore the height of the vertebral body and form voids in the spongy bone tissue. These operations to restore the height of the vertebral body are called kyphoplasty and vertebroplasty and are performed in the treatment of a compression fracture of the vertebral body.

Conservative treatment of a compression fracture of the spine with a decrease in the height of the vertebral body includes:

  • compliance with bed rest in the acute period
  • physiotherapy (UHF, SMT, TENS, etc.)
  • therapeutic gymnastics
  • wearing a special locking extension brace

Wearing an extensor (extensional) brace in the treatment of a compression fracture of the spine with a decrease in the height of the vertebral body.

Wearing an extensor (extensional) brace for compression fractures of the spine helps to straighten the place of the compression fracture of the vertebral body and creates additional fixation along the axis of the spine.

Wearing an extensor (extensional) brace in the treatment of a compression fracture of the spine with a decrease in the height of the vertebral body.

The duration of wearing an extensor (extensional) corset on average can be from 1.5 to 2 months from the moment of occurrence of a spinal fracture.

To reduce the pain syndrome in compression fractures of the vertebrae, an intranasal spray "Miakaltsik" (Calcitonin) is recommended.