What is a spine fracture?
In trauma very often patients diagnosed with a spinal fracture. Any injury to the skeletal apparatus is fraught with serious consequences. The human spine is the basis of all bone framework. Attached to the bone. It is the vertebral canal which contains the spinal cord. When damage to the nerves in the spine due to a fracture a person at risk for life remain disabled. Fracture can occur in individuals of any age and gender, including children. What are the varieties of fracture of the spine, the symptoms and treatment of this pathological condition?
The structure of the spine and its functions
The spine is part of the human skeleton that consists of 33-34 vertebrae. The latter are placed above each other. Between them is cartilage that function as shock absorption. Thanks to this disc, the spine has mobility. There are joints and ligaments. In the spine there are several regions: cervical, thoracic, lumbar, sacral, and coccygeal. Normal spine has curves. They are called lordosis and kyphosis. Fracture can occur in any Department.
The main functions of the vertebral column are:
- protection of the spinal cord;
- support function;
- involved in motor acts.
The spine trauma observed vertebral fracture (one or more). Often at the same time damaged blood vessels, muscles, ligaments. In the case of spinal cord injury occurs life-threatening condition.
Features of fracture of spine
Fractures of the spine in children and adults there are several types. Depending on the mechanism of injury distinguish the following types of fractures:
There is another classification that takes into account the localization of damage. Often there are compression fractures. They differ in that the compression of the vertebral column with displacement of the vertebrae, causing the distance between the vertebrae decreases. This happens in case of a fall from height at the back. The most severe are flexion-extension fractures. They occur during car accidents.
Strong blows to the torso can cause a rotational fracture. Thus there is abnormal rotation of the spine around its axis. Fracture of the thoracic spine or any other can be single and multiple. In the first case, only damaged 1vertebra. In some cases, doctors have to deal with comminuted fracture of the spine. Damage can occur with gunshot wounds. Such fractures are characterized by the fragmentation or separation of the vertebrae. Compression injury to the vertebral column is divided into 3 degrees. It is based on the change of the height of the vertebrae.
Causes damage to the spinal column can be very different. The main causes of a fracture are:
- falling from a great height (2 meters);
- a fall from a standing position;
- a stab in the back;
- shrapnel in the blasts;
- drop weights on your back;
- motor accident.
The most common cause is falling from a height. This can occur when an unsuccessful jump, down the stairs, jump with a parachute. Cervical spine can be damaged if you fall on your head. In case of a fall on the buttocks injured lumbar or sacrococcygeal Department. Compression of the cervical vertebrae can occur in drivers of cars in an accident. A sudden stop contributes to the movement of the head by inertia, whereas the body of man is fixed by the seat belt.
The signs of fracture of the cervical, thoracic or lumbar vertebra are often found in athletes. It can be gymnasts and individuals involved in various martial arts. The symptoms of fracture of the spine can occur in the workplace, in domestic environment, in exercise. A fracture of any bone occurs when exposed to high impact forces. Predisposing factors such pathological conditions are: osteoporosis, advanced age, metabolic disorders, the presence of tuberculosis infection.
A spinal fracture is easy to recognize the complaints of patients. The symptoms determined by the localization of fracture. The defeat of the cervical spine is characterized by the following features:
- noise in the ears;
- difficulty or inability to rotate the neck;
- muscle tension;
- the difficulty swallowing.
This files most often damaged 1 or 2 cervical vertebra. When fractured 1 vertebra (Atlanta) the pain is localized in the occipital region or upper neck. She can give in the shoulder girdle or hands. In severe cases (if damaged structures are oblong or spinal cord) may develop paralysis of the limbs. Often sensitivity is disturbed. If the fracture affects 3 vertebra of the neck, possiblefatal.
Elderly people often have fractures of the thoracic spine. In this situation, may experience chest pain, partial paralysis of the legs, numbness. When damage to the lower thoracic vertebrae may experience disorders of the pelvic organs. Patients complain of a violation of the excretion of urine and the process of defecation. In such a situation, it is necessary to organize immobilization.
A displaced fracture may be localized in the lumbar region. A fracture of this Department is characterized by the appearance of pain in the lumbar region, loss of consciousness, claudication, impaired urination. Perhaps the development of asphyxia and shock. Such patients take a forced position (lying on back). Paralysis of the legs is formed in the complete severing of the spinal cord. Less likely to diagnose a fracture of the sacrum or coccyx. The main complaint of the victims pain. It is acute, it becomes stronger when urinating or during sexual intercourse.
The consequences of fractures of the spine can be different. They depend on the severity. Possible consequences can be:
- root compression;
- compression of the spinal cord;
- the occurrence of the hump;
- compression myopathy;
- segmental instability;
- the development of sciatica;
- chronic pain syndrome;
- respiratory failure;
- the development of spondylosis;
- the formation of callus;
- the formation of a hernia;
- nezareatmene vertebra;
- lateral curvature of the spine.
With the development of paralysis and paresis, the formation of thrombosis or congestive pneumonia.
In the case of an accident, it is necessary to provide first aid. It is held to prevent other possible complications. First aid includes:
- immobilization of the victim;
- proper transportation;
- the use of painkillers.
If you suspect a fracture victim should be laid back on a hard surface. He can't move. In case of a neck injury, it needs to be fix with a special collar if there is one available. You first need to call the ambulance. If there are painkillers, they are required to file to the victim. At the organization of first aid are prohibited:
- often to shift the victim;
- try to straighten the vertebrae;
- to give the person sitting or standing position;
- to givehuman pain killers in the form of pills, if swallowing is impaired.
For confirmation of the diagnosis is required to examine the victim. The main method of diagnosis of fracture of the spine is x-ray examination. If you suspect a spinal cord lesion can be applied to MRI or CT. Before x-ray examination is an external examination. By palpation examination, the doctor determines the possible level of the fracture. By palpation can determine the presence of fragments (when shrapnel wound). X-ray study is available in front and side projection. For the assessment of spinal cord appropriate to the conduct of myelography.
In some cases a puncture of the spinal canal. Additional methods of research at suspicion on a fracture include: definition of bone density, General blood test, a bone scan. If the damage to the lower spine (lumbar and Sacro-coccygeal) may be rectal or vaginal examination. In this situation it is necessary to determine the presence of bone fragments. In the case of a fracture of the thoracic definitely is evaluated the condition of the heart. This is ECG.
Healing of the fracture
In the absence of complications start with conservative treatment. It involves the use of pain medication, massage, the wearing of a collar or corset, strict bed rest, restriction of physical activity, use of antibiotics, vitamins and minerals. Of painkillers used "Ketorolac", "Ibuprofen", "Nimesulide". Spine traction is used less often. If the damage thoracic patient should wear a corset. Bed rest is required to comply for one or several months. The patient should sleep on a special orthopedic mattresses. After this period the victim has to wear special orthopedic devices (corset or collar).
Conservative treatment may include physical therapy (phonophoresis, magnetotherapy). When fracture of the coccyx may be administered enemas. Antibacterials should be used only in case of infection. To eliminate the pain syndrome often used anesthetics, or is cryotherapy (treatment with cold). Equally important is rehabilitation after a spinal fracture. It involves massage, gymnastic exercises (physical therapy).
This is the final stage of therapy. You need to remember that conservative treatment is justified only in uncomplicated fracture without displacement of the vertebrae.
In the casecomplications recovery posture of the spine is performed through surgery.
The type of operation depends on localization of fracture and complications, and it can be performed by identifying transarticular clamps or special plates laminectomy (with a comminuted fracture).
Prevention of fractures
Fracture of the spine is easier to prevent than to treat, because during the treatment and rehabilitation of a person loses the ability to work, all it gives him a lot of inconvenience. To prevent fracture, you need to:
- to observe safety in the workplace and at home;
- to comply with the rules of the road;
- to continue extreme sports;
- when carrying out work at height to use the tether;
- to fasten the seat belts and the passengers during driving.
The prognosis for life and health depends on many factors: circumstances of injury, force of impact or drop height, the presence of complications, age and condition of the victim, speed of medical assistance. Often even in the absence of complications, the victims die. The main cause of death - shock. In the case of successful treatment for brain damage in victims can be saved movement disorders (paresis and paralysis). Thus, fracture of the spine applies to urgent conditions requiring immediate care.