Compression fracture of the spine

Compression fracture of the spine is a one-stage pressure on the spinal column, and compression, and its flexion. The pressure is excessive for the front structures of the spine, especially for the vertebrae itself and for more vulnerable discs. The front part of the vertebral body is literally squashed and becomes like a wedge. The rear department, compensating, begins to break into the canal of the spine and squeezes the canal of the spinal cord. This is the most dangerous form of fracture, which, fortunately, is not so common. Thus, not only the refraction of the spine occurs, but also its compression. That is why the fracture is called compression, as the squeezed front wall is compensated by squeezing out the rear part.

Compression fracture of the spine is typical for the area of location of the 11th and 12th thoracic vertebrae, as well as the first lumbar vertebra. Localization in other areas is possible, but less common.

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Epidemiology

Very vulnerable to compression fractures of the elderly due to the fragility of the bone system as a whole and the presence of many concomitant chronic diseases. Often, a compression fracture can be a consequence of pathological deformations of the bone system, as a result of which the process of reducing bone density begins.

[3], [4], [5], [6], [7], [8]

Causes of the compression fracture of the spine

The most common cause of such an injury are unsuccessful landings after jumps from height and various automobile, transport accidents.

Symptoms of the compression fracture of the spine

Symptoms that characterize the compression fracture of the spine: 

• A sharp blow, a trauma causes a characteristic acute, piercing pain in the vertebral column itself, instantly transmitted into the hands or feet, everything depends on the localization of the fracture. 
• Almost immediately there comes a strong weakness and a feeling of numbness, which indicates a rupture of nerve endings. 
• With slow, chronic destruction, which happens in the case of destruction of bone tissue by osteoporosis, pain sensations are usually tolerable, they grow parallel to the process of deformation of the spine. 
• The most severe injuries, complicated, cause paralysis of the lower body.

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Forms

Compression fracture of the spinal column can take two forms - complicated and uncomplicated.

Fractures without complications, that is, without threatening spinal cord injuries, are also divided into subspecies:

1. The vertebral body is squeezed until the height is less than half;
2. Pressure reduces the height of the vertebral body by half;
3. The height of the vertebra decreases significantly - more than half.

Fractures of the spine with complications - this is threatening not only health, but also life trauma. With a complicated compression fracture, not only the vertebrae but the spinal canal are injured. This form of statistics is found in only 5-6% of all diagnosed injuries associated with the musculoskeletal system. Most often injured cervical vertebrae, as the most vulnerable and fragile, then there are vertebrae of the sternum and lower back. A gross, mechanical injury that affects the vertebrae of C1, as well as C2, is considered fatal. Vertebrae with a complicated form of compression fracture are not so much fractured as they are subjected to dislocations and cracks, as a result - extended or broken arches are pressed into the soft tissues of the thoracic region, and then into the spinal cord. Since the sternum has very little spare unfilled space, deformed parts of the vertebrae damage the spinal cord, compensating for its location. In the thoracic region, the vertebral fractures Th11 and Th12 are the most susceptible. In the lumbar region, where the most axial load is, the vertebrae of level L (1 and 2) are injured.

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Diagnostics of the compression fracture of the spine

• Primary visual examination of the doctor and collection of anamnesis is mandatory in cases of uncomplicated fracture; 
• Mandatory are neurological tests that determine violations of spinal function, the degree of damage to nerve endings and the state of the peripheral nervous system; 
• The X-ray diffraction pattern is carried out in a complex way - in several projections, a direct and lateral picture is standardly made, other indications are possible according to indications; 
• Most often, the primary X-ray is specified and specified by a computer tomography survey. On the CT scan, the structure of the damaged vertebrae, muscle and nervous tissue is clearly visible. Possible and myelography - X-ray of the spinal cord. Magnetic resonance imaging is only indicated if there is a suspicion of serious injury to nerve tissue.

Modern medicine for the purpose of preventive actions and due to the extremely wide spread of osteoporosis, strongly recommends that a densitometric examination be performed for all women who have crossed the threshold of the fiftieth anniversary. This method allows you to accurately assess the condition of the bone tissue of the spine and take timely measures to prevent compression fracture of the spinal column.

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Treatment of the compression fracture of the spine

Conservative therapy

As a rule, uncomplicated fractures do not imply surgical intervention. The first stage of conservative action is the appointment of strong analgesics. 

Requires bed rest, maintaining maximum immobility, including fixing the body with corset accessories and recliners. Such fixing helps to reduce the compression pressure and neutralizes the possibility of displacement (collabo- ration). This regimen lasts until the end of the period of fusion of the fracture (consolidation), usually it lasts up to 14 weeks. 

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Surgical treatment of compression fracture of the spine

Surgical intervention is indicated in the compression trauma of the spinal cord itself, and the operation helps restore the stability of the spine fractured in several places. The operation helps to release the pinched nerve endings and prevent further compression of the spinal cord. Operations are conducted in several ways: 

• With the front access, when access to the spine is opened by cutting the front of the sternum or its lateral zone. Often an implant is immediately placed on the place of the destroyed vertebra - a prosthesis of the body or the vertebra (cage). 
• With the help of the rear access, when the skin is cut from the back. This method is used most often in complicated fractures, when the spinal cord is injured. On the damaged vertebrae, fixing devices - screws can be installed, so the vertebral column is fixed and returns to the state of a single conglomerate.

Compression fracture of the spine, despite the fact that it has an uncomplicated form, is considered a serious trauma requiring immediate hospitalization and urgent therapeutic actions. Especially dangerous are cases of complicated fractures, when the account goes literally for a minute. Minor injuries and bruises are inevitable for each of us, however more severe strokes and injuries in the spine may deprive a person of at least mobility, as a maximum of life. Therefore, you should carefully and carefully treat the main support of the body - the spine.