Compression fracture of the spine is a deformation (compression) under the influence of increased vertical load of one or more vertebrae. It may be due to a fall, shock, unsuccessful diving, or to be the consequence of diseases, reducing bone density (osteoporosis) or causing its destruction (cancer, tuberculosis).
Damaged and strangled vertebrae becomes wedge shaped: its front side height is reduced, and the rear part retains its original size.
Treatment of mild compression fractures of the spine is held conservatively.
Surgery is required when the vertebrae are severely deformed and lost their stability. Medicine has an arsenal of sparing methods, but ull abdominal surgery is indicated for complicated fractures, when the spinal cord or nerves involved.
Treatment of vertebral compression fracture is aimed to
The course of the treatment prescribed by the doctor based on the results of prior examination and it depends on the:
The compression ratio (the proportion of vertebral height loss of the original size) is visually evaluated by the doctor on the data of X-rays or MRI diagnosis. Totally, there are three of them:
Displaced fracture of the vertebrae or the fracture with the formation of bone fragments, which irritate nerve endings or compress the spinal cord, are classified as complicated.
Fracture of the lumbar spine often occurs because of falling from a height and landing on the feet, when the pointed vertical load amplifies with sharp bending. Treatment of the lumbar compression fracture begins with competent transportation. It is necessary to put the injured on a hard surface and enclose the hard roller in the lumbar area. During the movement, the body position should be maximally even and fixed.
Treatment with I-II degree of compression does not require surgery. Patients are prescribed:
Restrictive measures and their duration shall be appointed individually by the physician. The patient should be in a hospital. When strictly following to prescriptions, a gradual self-healing of damaged bone occurs.
During treatment, physiotherapy and massages are connected, and gymnastics in the rehabilitation period.
When loosing of vertebral height of more than 50% and violating its stability, sparing (invasive) treatments are appointed. The traumatic effect on the body tissues is minimal in this case and hospitalization is not required; the procedure itself and the recovery period are short.
The surgeon inserts a needle into the vertebral and injects through into internal cavity a special solution, the bone cement. Spine support ability during this neuroradiological procedure is restored on the operating table. The operation is performed under local anesthesia and X-ray observation, its efficiency of about 90%.
After vertebroplasty, patients must to rest about 2 hours, and to restrict locomotor activity the next day.
The method is aimed at eliminating drawdown of vertebra with subsequent fixation of the restored form with the bone cement.
Through two small incisions physician gets access to the site of injury, introduces into the vertebra blown away synthetic chamber, inflates it like a ball, thereby restoring the height and geometry of the vertebra, and, then, enters the cementitious composition and fixes the result.
When burdened with compression fractures of the III degree with fragments of bone or displaced vertebra hurting the spinal cord and nerves, decompression is required – eliminating a compressive force, removal of solid fragments and installation of metal implants to replace the damaged vertebrae. Such manipulations are carried out in the open spine.
It is especially important revealing the injury timely, because the children pain is not always clearly expressed, they can tolerate, not recognizing or fearing punishment for the prank and negligence. If the child fell, unsuccessfully jumped from a height on the physical education, teacher needs to inform the parents, and they, in turn, must immediately bring the child to the doctor.
Not timely recognized compression fracture in children is long-term and more serious than in adults. At the same time, they are difficult to get to bed and dose activity.
The course of conservative treatment of spinal compression fractures in children will be more effective in a specialized sanatorium, under the clock medical supervision, where there is an opportunity to be lying on the lessons, undergo regular inspection, keep proper diet, engage in physiotherapy.
If the fracture is simple, it is not necessary to wear a corset, so as not to inhibit the growth of the bones, it is prescribed only in particularly difficult cases (damage of more than 3 vertebrae).
With strict adherence to medical recommendations treatment, rehabilitation and recovery from compression fractures in children are quicker than adults. Prognosis of full recovery in 1,5-2 years based on examination.
In the elderly often suffering of osteoporotic, compression fractures of small X-XI thoracic vertebrae area may occur, for example, even because of a nasty cough. Pain syndrome is mild and does not cause much concern. Successful treatment of compression fractures of the thoracic in these cases depends on the timely turning to the doctor and passes conservatively; a vertebra is restores in 12-14 weeks.
In general, treatment and recovery after compression spine fracture in the elderly take more time because of the weakness of the skeletal system, a weakened immune system, obesity, and metabolic disorders. Older people are designated a longer bed rest, diet, they need help to roll over, so as not to have formed bedsores, massage.
After compression fracture, recovery occurs through a gradual build-up of physical activity by changing the physical therapy complexes.
The first 1.5-2 weeks, patients perform basic exercises to relieve muscle tension, a month after the injury go to complicated complex with the exercises to restore functions of the stomach, lungs, heart, circulatory and muscular system formation; after 40 days moderate complication is added and after 2 months go to load in standing position. Gradually, it is possible to proceed to the normal way of life, and start swimming.
The peculiarity of spinal compression fractures treatment is its long duration. Limited mobility, stretching, corset, rigorous gymnastics, massage, and swimming – all of that needs patience and only strict compliance with the entire medical advises could protect against complications. Otherwise, the old compression fracture treatment is not finished until the end, will painfully remind itself throughout life.