Compression fracture of the spine - Causes, symptoms and treatment. MF.
The vertebral column consists of separate bones - vertebrae. The vertebra, as well as any bone of the body, can break down - this is called a compression fracture of the spine. The most common compression fractures occur in the lower thoracic and lumbar spine.
Causes of compression fractures of the spine
Compression fractures of the spinal column are caused by excessive pressure on the vertebral body. At a fracture of the vertebra, his body acquires a wedge shape with a vertex anteriorly. The internal tissue of the vertebral body is destroyed or compressed. It can occur when the spine is tilted anteriorly with a high axial load. Such a mechanism is most often encountered when jumping from height to foot.
There are several causes of compression fractures. If the vertebra is too weak to maintain normal axial loads, then a slight pressure may be required to destroy it. Most healthy bones can withstand pressure, and the spinal column is able to absorb the impact. However, with severe significant stress, one or more vertebrae can break down.
One of the common causes of compression fractures of the spine is osteoporosis. This systemic disease leads to a loss of bone mass, weakening the bone, making it incapable of carrying normal loads. Eventually, a fracture can happen with the usual tilt anteriorly. Osteoporosis is the most common cause of compression fracture.40% of all women by the age of 80 had at least one compression fracture of the spine. Osteoporotic compression fracture causes a decrease in growth and the formation of acute kyphosis( hump), especially in the elderly.
Symptoms of compression fracture of the spine
If a compression fracture is caused by a sudden injury, the first manifestation will be a sharp pain in the spine, arms, or legs. You can also feel weakness and numbness, if at the fracture the nerve structures of the spinal column were damaged. If the destruction of the vertebra is gradual( with osteoporosis), the pain will be moderate, gradually increasing. In severe forms of compression fractures, the posterior parts of the vertebral body can be displaced into the spinal canal, exerting pressure on the spinal cord. Fortunately this is not common.
Diagnosis of compression fracture of the spine
Before the doctor can diagnose a compression fracture of the spine and take any action regarding treatment, he must collect your complaints and anamnesis( the history of what happened to you).It is important to differentiate the compression fracture from other diseases causing pain in the spine or back and determine: what is the cause of the problem. Next, your doctor will appoint a set of diagnostic procedures to clarify the diagnosis and determine the tactics of treatment:
- Neurological examination includes checking the function of the spinal cord, nerve roots and peripheral nerves.
- Radiography of the spine in two projections( direct and lateral) will indicate a damaged vertebra.
After your radiography, your doctor may prescribe a CT scan( CT) to study the structure of the damaged vertebra in more detail. Similarly, in parallel with CT, it is possible to carry out myelography to assess the state of the spinal cord at the fracture level.
- MRI is usually performed with suspicion of damage to the spinal nerve structures.
- Densitometry. All women after 50 years with a diagnosed compression fracture of the spine should perform a densitometry for osteoporosis.
Treatment of compression fracture
After the complex of necessary diagnostic procedures is carried out and the diagnosis is established, a treatment and rehabilitation plan is drawn up. It is worth remembering that the compression fracture of the spine requires prolonged treatment, including strict adherence to the regime and self-discipline. Treatment is always under close supervision of the doctor. The choice of method of treatment will be determined by the severity of the disease and the patient's condition. With an easy degree of fracture, mainly conservative treatment is used, whereas in severe cases, surgical treatment is most likely to be required.
Conservative treatment
Conservative therapy includes analgesic therapy and a set of physical exercises. At the first stages of treatment, the patient is placed on a special hard bed, which must also be tilted, and completely eliminate physical stress for a while, in order for the spine to be able to recover. In the next stages of treatment, you can use massage, special exercises and physiotherapy.
Depending on the time that had passed from the time of injury, age characteristics and the nature of the disease, with compression fracture of the spine, apply LPT.Gymnastics with compression fracture of the spine helps to restore the axis of the spine and its natural curves, strengthen the muscular corset of the back and trunk, restoring the usual mobility and flexibility of the spine. After six months of training, normal working capacity of patients with compression fracture of the spine is usually restored.
It is also recommended to wear a corset that will help a faster recovery after a fracture and create an additional fixation for the spine. To achieve the effect of wearing a corset should be at least two months. In complex cases of vertebral fractures, radical treatment methods may be required, so for fractures that are associated with damage to the nervous structures, an open surgery will be required.
Rehabilitation after compression fracture of the spine
Rehabilitation after a compression fracture of the spine, if there is no damage to the nerve roots, has as its goal the return of people to normal life. Recovery after a compression fracture of the spine mainly involves the use of physiotherapy, but not earlier than a month or one and a half after the injury. For the removal of the pain syndrome, electrostimulation, cryotherapy( cold treatment) and massage are sometimes used. Thanks to physiotherapy procedures, correct posture is restored, mobility and flexibility of the spine improves.
In the further rehabilitation of rehabilitation, the following tasks are:
- Removing the pain syndrome
- Restoring the geometry of the spinal column bends. Elimination of lateral and antero-posterior dislocations.
- Unlocking the motor function. Restoration of the function of the diaphragm and chest.
- Very often compression fracture entails a disruption in the work of the respiratory biomechanics. It is hard to inhale or exhale, there is a shortage of air.
- Restoration of blood supply in the area of injury.
- Creation of conditions for the most complete regeneration of tissues in the area of trauma.
- Creation of a powerful muscular skeleton in the area of trauma and in other parts of the spine.
- Restore the maximum volume of spinal motion in the area of injury.
The solution of these problems is in general a new approach in the rehabilitation of patients after a compression fracture. Usually recommend complete rest, wearing a corset, treatment by position, which leads to a prolonged bed rest, to lifting the load, reducing the motor function. Just notice that patients after a long stay in the pastel get depressed, which sometimes is transformed into serious psychological and mental disorders. Active rehabilitation therapy should be complemented by psychological rehabilitation.