Causes of spinal fracture: Causes of Spinal Fractures
Osteoporosis and Spinal Fractures – OrthoInfo
Fortunately, most people who suffer a vertebral compression fracture get better within 3 months without specific treatment to repair the fracture. Simple measures, such as a short period of rest and limited use of pain medications, are often all that is required. In some cases, patients are instructed to wear a brace to restrict movement and allow the vertebral compression fracture to heal.
It is important to note that when the fracture heals, the bone does not reform into its original rectangular shape, but if it is healed, it will not cause further collapse.
If your doctor has also diagnosed osteoporosis, you are at increased risk for additional vertebral compression fractures and other fractures, such as to the hip and wrist. Your doctor will address treatments for bone density loss during this time.
If you have severe pain that does not respond to nonsurgical treatment, surgery may be considered.
In the past, the only surgical options available to patients with vertebral compression fractures involved extensive procedures. Today, vertebral augmentation procedures offer a minimally invasive alternative.
The two types of vertebral augmentation methods available are kyphoplasty and vertebroplasty. The best candidates for these procedures are patients who suffer severe pain from recent vertebral compression fractures. If you are a candidate for kyphoplasty or vertebroplasty, your doctor will talk with you about which procedure may be better for you based on the type of vertebral compression fracture you have.
Kyphoplasty. In a kyphoplasty, the surgeon inserts a needle into the fractured vertebra using an X-ray for guidance. The surgeon then inserts a small device called a balloon tamp through the needle and into the fractured vertebra. The balloon tamp is inflated from within the vertebra, which restores the height and shape of the vertebral body. When the balloon tamp is removed, it leaves a cavity that is filled with a special bone cement that strengthens the vertebra.
Kyphoplasty can be performed using general anesthesia (which puts you to sleep) or with a local anesthesia (which numbs your body around the fracture site). For this procedure, the patient lies face down on the operating table, and the surgeon accesses the spine from the back.
After surgery, patients can go back to all their normal activities of daily living as soon as possible with no restrictions.
Vertebroplasty. Vertebroplasty is a technique similar to kyphoplasty, but the surgeon does not use a balloon tamp to create a space for the cement. Instead, the surgeon injects the cement directly into the narrowed vertebra. Like kyphoplasty, this procedure is performed while the patient is lying face down so that the surgeon can access the fractured vertebra from the back.
After this surgery, patients are encouraged to return to their normal, day-to-day activities as soon as possible.
Discuss with your surgeon which procedure may be better for you.
Several reports have been published on the results of vertebral augmentation procedures. In two large studies, the benefit of vertebroplasty was found to be very short term. In contrast, studies indicate that kyphoplasty may increase function and decrease pain more quickly than nonoperative treatment.
Your doctor will discuss realistic expectations for recovery if vertebroplasty or kyphoplasty is recommended for you.
Spinal Fracture | Boston Children’s Hospital
A spinal cord fracture is a break to the cervical, thoracic and/or lumbar vertebrae.
The spinal column is made up of many individual bony rings called vertebrae, joined together by muscles and ligaments. Flat, soft intervertebral discs separate and cushion each vertebra from the next.
Because the vertebrae are separate, the spine is flexible and can bend. Different regions of the spinal column have different names:
- The cervical vertebrae are those situated around the neck.
- The thoracic vertebrae are those situated in the chest region.
- The lumbar vertebrae, along with the sacrum, make up the lower back.
The spinal column houses the spinal cord, which consists of nerves that carry and receive signals to and from the arms, legs, and many internal organs.
What causes a spinal fracture?
There are many causes of spinal fractures in children. The more common injuries occur when the area of the spine or neck is bent or compressed as in the following:
- birth injuries, which typically affect the cervical vertebrae (in the neck area)
- motor vehicle accidents (where your child is either riding as a passenger in the car or is struck as a pedestrian)
- sports injuries
- diving accidents
- trampoline accidents
- violence (gun shots or stab wounds)
What are the symptoms of a spinal fracture?
Your child may have varying degrees of symptoms, associated with the severity and location of the fracture and whether or not the spinal cord has been compressed. A severe compression fracture may involve the spinal cord or nerve roots, as they are draped over the sudden angulation of the spine. This may cause severe pain, a hunched forward deformity (kyphosis) and/or paralysis. Other symptoms include:
- pain in the affected area (from mild to severe)
- inability to walk or move normally
- deformity or an unnatural angle in the area
If you suspect a spinal injury, call for emergency help and do not attempt to move your child. Medical personnel need to determine the extent of the damage as soon as possible. Immobilize your child’s head, neck and spine by padding them with towels, blankets, or jackets.
How Boston Children’s Hospital approaches spinal fractures
Boston Children’s Spinal Program in nationally and internationally known for its innovation and leadership, offering the latest diagnostic and treatment approaches. Our physicians with the Spinal Program see more than 6,000 outpatients and perform more than 300 spinal operations.
Compression fractures of the back
Compression fractures of the back are broken vertebrae. Vertebrae are the bones of the spine.
Vertebral compression fractures; Osteoporosis – compression fracture
Osteoporosis is the most common cause of this type of fracture. Osteoporosis is a disease in which bones become fragile. In most cases, bone loses calcium and other minerals with age. Other causes may include:
- Trauma to the back
- Tumors that started in the bone or spread to the bone from elsewhere
- Tumors that start in the spine, such as multiple myeloma
Having many fractures of the vertebrae can lead to kyphosis. This is a hump-like curvature of the spine.
Compression fractures can occur suddenly. This can cause severe back pain.
- The pain is most commonly felt in the middle or lower spine. It can also be felt on the sides or in the front of the spine.
- The pain is sharp and “knife-like.” Pain can be disabling, and take weeks to months to go away.
Compression fractures due to osteoporosis may cause no symptoms at first. Often, they are discovered when x-rays of the spine are done for other reasons. Over time, the following symptoms may occur:
- Back pain that starts slowly, and gets worse with walking, but is not felt when resting
- Loss of height, as much as 6 inches (15 centimeters) over time
- Stooped-over posture, or kyphosis, also called a dowager’s hump
Pressure on the spinal cord from hunched over posture can, in rare cases, cause:
Exams and Tests
Your health care provider will perform a physical exam. This may show:
- A humpback, or kyphosis
- Tenderness over the affected spinal bone or bones
A spine x-ray may show at least 1 compressed vertebra that is shorter than the other vertebrae.
Other tests that may be done:
- A bone density test to evaluate for osteoporosis
- A CT or MRI scan, if there is a concern that the fracture was caused by a tumor or severe trauma (such as a fall or car accident)
Most compression fractures are seen in older people with osteoporosis. These fractures often do not cause injury to the spinal cord. The condition is usually treated with medicines and calcium supplements to prevent further fractures.
Pain may be treated with:
Other treatments may include:
- Back braces, but these may further weaken the bones and increase the risk for more fractures
- Physical therapy to improve movement and strength around the spine
- A medicine called calcitonin to help relieve bone pain
Surgery may be done if you have severe and disabling pain for more than 2 months that does not get better with other treatments. Surgery can include:
Other surgery may be done to remove bone if the fracture is due to a tumor.
After surgery you may need:
- A brace for 6 to 10 weeks if the fracture was due to an injury.
- More surgery to join spine bones together or to relieve pressure on a nerve.
Most compression fractures due to injury heal in 8 to 10 weeks with rest, wearing of a brace, and pain medicines. However, recovery can take much longer if surgery was done.
Fractures due to osteoporosis often become less painful with rest and pain medicines. Some fractures, though, can lead to long-term (chronic) pain and disability.
Medicines to treat osteoporosis can help prevent future fractures. However, medicines cannot reverse damage that has already occurred.
For compression fractures caused by tumors, the outcome depends on the type of tumor involved. Tumors that involve the spine include:
- Breast cancer
- Lung cancer
- Prostate cancer
- Multiple myeloma
Complications may include:
- Failure of the bones to fuse after surgery
- Spinal cord or nerve root compression
When to Contact a Medical Professional
Call your provider if:
- You have back pain and you think you may have a compression fracture.
- Your symptoms are getting worse, or you have problems controlling your bladder and bowel function.
Taking steps to prevent and treat osteoporosis is the most effective way to prevent compression or insufficiency fractures. Getting regular load-bearing exercise (such as walking) can help you avoid bone loss.
You should also have your bone density checked periodically, especially for women that is post-menopausal. You should also have more frequent checkup if you have family history of osteoporosis or compression fractures.
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Vertebral Fracture: Practice Essentials, Epidemiology, Pathophysiology
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Pathological Spine Fracture – Ortho Illinois
Pathological spine fractures are the result of an underlying disease process that affects the spine. They are called vertebral compression fractures and are common, and frequent in the elderly. They may be caused by osteoporosis, Paget’s disease, other diseases and spinal infections (osteomyelitis). Frequently pathological spine fractures result from tumors that start in the spine or from metastatic cancer. 10-15% of cancers affect the spine.
Management of a pathological spine fracture will depend on whether the cause is benign or malignant. In addition to a complete medical history and physical exam, x-rays, MRI and CT scans can detect and evaluate pathological spine fractures.
Symptoms depend on the underlying disease or disorder. Symptoms of a pathological spine fracture may include: Pain in the back, legs and arms and neurological impairment.
Nonsurgical treatments are recommended for less severe pathological fractures. These include pain medications, bracing, and limiting physical activity. Surgery may be considered if the spine is unstable or where there is significant compression of the spinal cord and/or nerves.
What is osteoporosis?
Osteoporosis is a benign metabolic disorder that reduces bone density that causes weak and brittle bones. Osteoporosis increases the risk that even a minor or no trauma will break the bone. Osteoporosis is the most common cause of compression fractures in women who have gone through menopause. But osteoporotic fractures also affect people who have a history of long-term use of steroid medication, chemotherapy, and radiotherapy.
What is Paget’s disease?
Paget’s disease is a benign metabolic bone disorder. The cause is unknown. But it weakens the bone and causes pathological fractures.
What is Osteomyelitis?
Spinal Osteomyelitis is an infection of the vertebrae that has spread through the blood. It can occur after surgery or spontaneously in people with malnutrition, HIV, IV Drug use, cancer, diabetes, obesity and immune suppression.
Symptoms include fever, chills, headache, a stiff neck, pain that is worse at night, weakness, numbness, and tingling. It can cause a spinal abscess and can result in paralysis. It typically affects the lumbar spine.
They are usually treated with antibiotics and antifungal mediations either orally or via an IV. Surgery to remove the infected tissues and bacteria may be needed when the infection creates spinal instability and weakness, which create the risk of spinal fracture.
Which metastatic cancers affect the spine?
- Multiple Myeloma
- Thyroid, and
At Ortho Illinois Spine Care our board-certified, fellowship trained orthopedic and neuro surgeons are experts in the diagnosis and treatment of spine disorders. Ortho Illinois Spine Care is a regional spine center for people in northern Illinois and the Chicago region who are suffering with neck and back pain. Our goal is to help relieve our patients’ pain and restore their function so you can get back to the life they love.
Spinal Fracture – Causes, Symptoms, Diagnosis, Treatment
Spinal injuries that result in spinal fractures cause lot of discomfort, pain, difficulty in walking, or even paralysis in severe cases. Although pain relieving medications can help, injuries such as cervical spine fracture may warrant surgery.
Causes of Spinal Fracture
A spinal fracture may be caused due to following conditions:
- A high-energy trauma: This includes a violent accident that puts extreme pressure on the spine. For example, car crash, fall from height, accident during playing sports, or gunshot wound
- Osteoporosis: This is a condition in which the bones become weak and fragile due to decrease in mineral content. Osteoporosis is thought to be the most common cause of spinal fracture
- Tumors in the body that spread to the bones of spine
- Tumors that start in the spine
Symptoms and Signs of Spinal Fracture
The symptoms of spinal fracture vary based on the location and severity of the injury. A moderate-to-severe back pain signals spinal injuries. In addition, spinal fractures also cause muscle spasm, weakness, loss of control of the bowel or bladder, and paralysis if the spinal cord is affected. Spinal compression fracture that occurs due to osteoporosis may not show symptoms initially. However, over time symptoms such as severe back pain, loss of height or hump-like curvature of the spine may be observed.
Diagnosis of Spinal Fracture
Spinal injuries need a careful diagnosis in order to initiate the appropriate treatment. People with fractured spine may have to undergo several tests and examinations as described below.
During physical examination, a doctor examines vital signs such as breathing, heart rate and consciousness. The doctor may also check for signs of tenderness over affected area or signs of kyphosis (hump-like curvature) that occur due to osteoporosis.
An x-ray test can identify the fractured vertebrae.
Computed Tomography (CT) Scan
A CT scan uses an X-ray beam and a computer to generate a two-dimensional image of the spine. This test can determine the changes or fracture in the bones of spine.
Magnetic Resonance Imaging (MRI) Scan
MRI scan uses a magnetic field and radiofrequency waves to generate a detailed view of the spine. MRI scan can investigate an injury to spinal cord or the ligaments. This test can diagnose a spinal fracture caused by a tumor.
What are the Treatment Options for Spinal Fractures?
The main goals of treatment plan include reduction of pain, improving mobility, and managing osteoporosis. For better understanding, the treatment plans can be divided as medical and surgical.
The medical treatment focuses on pain management using medications such as non-steroidal anti-inflammatory drugs or opiates in severe cases, and bed rest. The spinal fractures that occur only through the vertebral body can be managed by using physical support such as braces or corsets for about 8 to 12 weeks. The braces restrict the movement of spine thereby reducing pain and improving healing process. The corsets are not recommended beyond 12 weeks as they may immobilize the spine and cause further bone loss.
Other physical treatment such as Transcutaneous Electrical Nerve Stimulation (TENS) may be used to improve movement and strength of the muscles around the spine. The underlying osteoporosis if present should also be treated.
Surgery is required in cases of severe fractures or when pain lasts for more than two months.
Surgeries performed to fix the fractured spine include:
Vertebroplasty and Kyphoplasty
These procedures are performed to treat spinal compression fractures mainly caused by osteoporosis and spinal tumors. Both the procedures involve injecting cement into the broken spine bone so that it does not collapse again. Kyphoplasty additionally involves insertion of a balloon initially, which is inflated to restore the height of the vertebrae. Both the procedures are generally safe, however some complications such as infection, bleeding or leakage of the cement into surrounding area may be observed.
Both the procedures are considered to be minimally invasive and may cost up to INR 75,000 each.
Spinal fusion permanently joins two vertebrae with the help of a bone graft. The bone graft may be obtained either from another part of your body (autograft) or from a bone bank (allograft). The vertebrae may also be joined together with the help of rods, screws, plates, or cages.
The complications associated with spinal fusion procedure include infection, damage to the spinal nerve, and damage to the surrounding vertebrae. These procedures are relative expensive amounting approximately INR 3, 60,000.
Prevention of Spinal Fractures
- Get treatment for osteoporosis
- Indulge in physical activities such as swimming and walking that can provide joint motion without stress
- Avoid sudden twists or putting too much pressure on the spine
- Practice good techniques for standing, sitting, lifting, and other regular activities
Spinal Fracture Specialist – Garden City, NY: Benjamin R.
Cohen, M.D., F.A.C.S.: Spinal Surgeon
What causes a spinal fracture?
Whether your fracture occurs in your neck (cervical spine), mid-back (thoracic spine), or lower back (lumbar spine), spinal fractures are usually caused by high-energy trauma, such as:
- Fall from significant height
- Car or motorcycle crash
- Sports accident
- Violence such as a gunshot wound
Fractures to your spine should always receive immediate medical attention due to the chance of nerve damage. Additionally, any event that can fracture your spine may cause other serious damage, such as a traumatic brain injury.
What causes a spinal compression fracture?
Spinal compression fractures occur when a vertebra collapses because it’s too weak to support the usual amount of weight carried by your spine. You may develop a compression fracture during a traumatic injury or when your spine is weakened by a tumor or infection. However, osteoporosis is the most common cause of a spinal compression fracture.
How are spinal fractures treated?
After you receive imaging and neurological tests, Dr. Cohen determines the best treatment based on the type of fracture. The first line of treatment is nonsurgical care, such as immobilizing your back to give the spine time to heal.
Dr. Cohen may recommend surgery when he needs to realign the bones, relieve pressure on the spinal cord, or stabilize the spine. He specializes in numerous procedures to treat spinal fractures; here are two examples:
Lumbar vertebral body replacement
When the vertebral body (the thick oval bone in each vertebra) is fractured, it causes significant spinal instability and often pinches spinal nerves. To repair this type of fracture, Dr. Cohen removes the fractured area and replaces it with a small metal cage.
The cage is filled with bone graft materials that stimulate bone growth. As the vertebral body heals, new bone grows through the cage, gradually fusing with the existing bone to restore bone.
Vertebroplasty and kyphoplasty
These procedures treat a compression fracture. During both procedures, Dr. Cohen inserts a hollow needle into the collapsed vertebra and injects bone cement. The cement quickly dries, restoring the vertebra’s strength and integrity, and stabilizing the spine.
The difference between the two is that kyphoplasty restores the bone’s normal height by using a balloon to expand the bone before injecting cement.
If you suffer a spine fracture, call Benjamin Cohen, MD, or book an appointment online to get exceptional fracture care.
90,000 Spinal fracture treatment
Description of the disease, symptoms and causes, methods of treatment.
Fracture of the spine – a pathological condition resulting from a violation of the integrity of the bone tissue of the spinal column. A spinal fracture is dangerous with complications that arise both instantly and in the long term. That is why this pathological condition is an emergency indication for hospitalization in a hospital.Treatment of a spinal fracture begins immediately with the prevention of respiratory failure and hemodynamic disorders.
According to the anatomical division into departments, a spinal fracture can be:
2) Thoracic department
According to the mechanism of injury, a spinal fracture is:
More about spinal fracture treatment
A spinal fracture is a consequence of injury, often combined with dislocation of the vertebral bodies.As a rule, sludge occurs under the influence of a strong blow to the back, or with a strong excessive overextension of the spinal column. Often, after a blow, the patient is in a state of passion for a long time, not realizing the severity of his condition, continues to walk freely until paresis or complete paralysis occurs. With injuries of the cervical spine, there may be an instant cessation of breathing and cardiac activity. The patient dies at the site of injury; resuscitation measures are usually ineffective.
There are many signs of a spinal fracture. First of all, neurological disorders are manifested in the form of paresis and paralysis, both of a separate group of muscles, arms and legs, and of the whole body. There is pain in the back, often acute. While maintaining physical activity, it is often she who forces the patient to be in a forced position. It is impossible to accurately determine the location of the spinal fracture according to the clinical picture, the signs are so variable – X-ray and tomography are required.
Forecast and outcomes
Due to the fact that a spinal fracture is often observed in people of working age, making them disabled, an urgent issue is the prognosis of further treatment and rehabilitation. With a partial loss of activity, especially in the upper limbs, the patient does not seriously lose his social activity. As a rule, complications are not observed in the case of maintaining the correct healthy lifestyle. Paralysis, leading to bed lifestyle, contributes to the appearance of dystrophic changes, the formation of blood clots and hypostatic pneumonia – the prognosis in this clinical situation is unfavorable.The five-year survival rate is low.
Compression fracture of the spine
Often spinal fractures occur due to falls from a height to their feet and other similar injuries, in which the spinal column experiences strong vertical loads. As a result, the vertebral body is destroyed, but off-axis displacements are rarely observed. Compression fracture of the spine, as it has already become clear, is more favorable and is relevant due to the fact that it often occurs in childhood, adolescence and young age.On the first day after the fracture, in the absence of other associated injuries, the patient may not be bothered by anything, and the pain appears only on the second and subsequent days. Note that no neurological symptoms can be observed in a compression fracture of the spine, only intense pain in the area of injury. With frontal displacements, a compression fracture of the spine can be aggravated by paresis and paralysis, depending on the damage to one or another nerve root.
As already mentioned, all spinal fractures are urgent indications for hospitalization, the treatment of which begins literally at the site of injury.If there is a suspicion of a fracture, the victim is carefully placed on a hard surface under conditions of complete immobilization and in this form is poisoned in a medical institution to establish an accurate diagnosis. Treatment of a spinal fracture in a hospital is carried out conservatively and surgically, depending on the type of injury, its location and symptoms. Various skeletal tractions give good results, especially when there are indications for them in the case of an uncomplicated flow.
Surgical treatment of a spinal fracture consists in strengthening the existing defect. Often it is necessary to make an implant of the vertebral body, since the previous one is destroyed. These techniques have proven themselves to be the best in the treatment of compression fractures. In any case, the fundamental point is rehabilitation and postoperative treatment, which raises many questions from patients and heated discussions in scientific circles. Spinal fracture treatment always requires an individual approach and techniques. In the conditions of the modern formation of neurosurgery and traumatology, there are dozens of approaches to choose a doctor, each of which has its own specific effectiveness.In particular, the treatment of a compression fracture of the spine, if previously required a long-term conservative approach, in the case when the vertebral body was completely destroyed; such patients remained disabled for a long time, and throughout their lives suffered from pain syndromes. Now, carrying out a small operation provides reliable guarantees for the return of previous health.
What are spinal compression fractures and how to treat
A spinal fracture is a fairly common injury.With a compression fracture, one or more vertebrae are compressed. In the first moments after injury, a person feels severe pain in the spine. In the future, the disease may be accompanied by the following symptoms:
- labored breathing;
- headache, dizziness;
- numbness of hands and feet;
- difficulty in turning the torso;
- increasing pain in an upright position or in a sitting position;
- reduction of pain in the supine position.
Since trauma can damage the spinal canal, without appropriate treatment, traumatic changes can affect the spinal cord, which often leads to disability. Therefore, at the first suspicion of a fracture, it is necessary to urgently consult a doctor.
Which doctor should I go to with a spinal fracture?
Fractures are diagnosed and treated by a traumatologist. Depending on the nature and degree of the injury, orthopedists, surgeons, neurologists, neurosurgeons and rehabilitologists join the treatment process.
Why you should contact the traumatologists of “Scandinavia”
Patients with spinal cord injury choose the Scandinavia clinic because:
- our traumatologists can provide urgent assistance at the first call and carry out all the necessary diagnostic tests;
- the clinic is equipped with modern X-ray machines and tomographs, which allows you to choose an effective individual treatment.
For patients who are indicated for surgical treatment (spondylosynthesis or vertebroplasty), we have equipped a comfortable hospital with spacious wards, comfortable beds, Wi-Fi in the clinic, and soft sofas.
Modern hospital, comfortable wards, all types of operations
How is the first consultation with a traumatologist going
At the first consultation, the doctor will clarify the complaints, take anamnesis and conduct an examination. Anamnesis includes questions about the nature of the pain and the circumstances of the injury; taking anamnesis helps to determine the cause and type of fracture.Inspection is necessary to establish the approximate location of the injury and the nature of the damage.
Diagnosis of spinal fracture
To determine how exactly the vertebra is broken, how extensive the damage is, the traumatologist uses hardware diagnostic methods:
CT and MRI are more accurate methods because they provide a detailed image of the spine.
Methods of spinal fracture treatment in “Scandinavia”
Our traumatologists treat minor injuries with conservative methods.Most often, it is necessary to wear a rigid corset, pain relievers and gymnastics to strengthen the muscles. For complex injuries, surgical intervention is indicated:
- vertebroplasty – the introduction of a cement solution to strengthen the vertebra through the game;
- spondylosynthesis – stabilization of damaged segments of the vertebrae using submersible implants.
If the vertebra cannot be restored, the doctor will suggest the placement of bone or synthetic grafts.It is possible to perform endoprosthetics of a vertebra or several vertebrae. In this case, a stabilizing system of plates and bridges will be installed to fix the spine.
Make an appointment with a traumatologist
You can make an urgent appointment with a traumatologist at the Scandinavia clinic by phone or online.
Compression fracture of the spine – treatment, symptoms, causes, diagnosis
Compression fracture of the spine , a fairly common injury.It occurs with simultaneous flexion and compression of the spinal column. This leads to a significant increase in pressure on the anterior structures of the spine – on the vertebral bodies and discs. When a compression fracture occurs, the vertebral body in the anterior part is flattened, acquiring the shape of a wedge. With a significant decrease in the height of the anterior parts of the vertebral body, the posterior part of the body can penetrate into the spinal canal and lead to compression of the spinal cord. Fortunately, such major fractures are rare.
Most often compression fractures of vertebral bodies occur in the region of the thoracolumbar junction (11-12 thoracic vertebrae and the 1st lumbar). But other localizations are possible. Such fractures occur when falling from a height, a transport accident. In older people, compression fractures can also occur with minor trauma. This is due to the increased fragility of bones due to osteoporosis. A compression fracture can be a complication of another medical condition that results in changes in bone density.
Uncomplicated spinal fractures (without spinal cord injury), depending on the amount of compression, can be divided into three degrees. 1 degree – decrease in the height of the vertebral body by less than ½ / 2 degree – decrease in the height of the vertebral body by ½. With the third degree of compression, the height of the vertebral body is reduced by more than ½.
If the fracture was caused by a significant external force, then at the time of injury, patients experience severe back pain. In some cases, pain can radiate (give) to the arms or legs.When nerve structures are damaged, weakness and numbness occur in the upper or lower extremities.
Fracture of pathologically altered vertebrae, which occurs with minor trauma, may be accompanied by only minor back pain.
A spinal x-ray is required to confirm a vertebral fracture. In some cases, computed tomography (CT) is necessary for a more detailed examination of the fracture area, detection of injuries indicating instability of the spinal motion segment.With this study, it is possible to diagnose damage to both bone structures and soft tissues. The image is obtained by digitally processing a variety of X-ray images taken at different angles and at different levels using a CT scanner, and presented as a series of cross-sections of the body.
If there is a suspicion of damage to the nerve structures (spinal cord, nerve roots), magnetic resonance imaging is mandatory. This modern painless study is the “gold standard” for diagnosing damage to the soft tissues of the body (spinal cord, nerves, ligaments, muscles, etc.)). The principle of operation of magnetic resonance imaging is to study the structure of soft tissues using electromagnetic waves. This completely safe and painless diagnostic method is currently widely used in neurosurgical and orthopedic practice.
Fractures of the spine can be accompanied by the occurrence of specific complications, including very serious ones, leading to the patient’s disability.
The most common complications are spinal instability, the development of kyphotic deformity and neurological disorders.
If, as a result of a compression fracture, the height of the vertebral body decreases by more than 50%, the risk of developing segmental instability increases significantly, which is the cause of chronic pain syndrome, rapid degenerative changes in the damaged segment, as well as damage to nerve structures.
Treatment of compression fractures of the spine in most cases includes taking analgesics, adherence to a protective regime and the use of special reclinators and corset belts.In some cases, surgical treatment is also necessary. In many cases, strict bed rest for several weeks should be recommended
In the treatment of compression fractures of the vertebrae and in the prevention of complications, the most important place belongs to physiotherapy exercises – a specially developed set of physical exercises aimed at creating a muscular corset capable of stabilizing the damaged segment of the spinal column. At the same time, physical exercise improves the blood supply to damaged structures, thus accelerating their regeneration and reducing pain.Massages and physiotherapeutic procedures prescribed in the complex treatment of compression fractures serve the same purpose. But it must be remembered that a compression fracture, like any other, goes through a number of stages in its course. A complex of therapeutic physical exercises should be prescribed individually, taking into account the stage of the process and the characteristics of a particular patient, carried out under the supervision of an exercise therapy doctor, a methodologist and an orthopedic traumatologist.
Medical and rehabilitation centers “Belyaevo” and “Losiny Ostrov” have everything necessary for the diagnosis and treatment of compression fractures of the spine at the highest modern level.
90,000 symptoms and treatment of osteoporosis in women
The disease can occur in younger people with risk factors. These include:
- asthenic (“fragile”) physique – osteoporosis of the spine often develops in thin women;
- Caucasian race;
- bad habits and eating disorders – smoking, excessive consumption of coffee and alcohol;
- insufficient intake of calcium into the body;
- endocrine pathologies;
- early onset of menopause in women;
- taking a number of hormonal drugs;
- genetic and environmental factors;
- low physical activity. 2
Osteoporosis without accompanying vertebral fractures does not lead to any symptoms. For a long time, the patient may not be aware of the presence of a disease.
The main and most dangerous symptom of spinal osteoporosis is low-energy vertebral fractures. They occur even with the slightest injury or without them. The moment of the fracture is accompanied by acute pain in the area of the affected vertebra. The pain syndrome is local in nature.It increases with movement, coughing and sneezing, as well as with palpation (feeling) of the affected vertebra area.
Typical localization of compression fractures is the lower thoracic or upper lumbar spine. Fractures of the sacrum are less common. In this case, the pain is localized in the lumbosacral region, sometimes radiating to the buttocks or lower limb. 3
Indirect (minor) symptoms of spinal osteoporosis are:
- progressive decrease in height (by 2 cm or more in 1-3 years or more than 4 cm from the height that was at 25 years old)
- pronounced thoracic kyphosis – if the patient stands against the wall, the distance between it and the back of the head will be more than 5 cm;
- The distance between the lower ribs and the ilium is less than or equal to the width of two fingers.
These symptoms indicate deformity of the spinal column due to the presence of one or more compression fractures. 4
Osteoporosis is often accompanied by neurological disorders. For example, with the defeat of the upper lumbar spine, pain is observed that spread to the abdomen, groin, along the anterior-inner surface of the thigh. This indicates the involvement of the spinal roots in the pathological process against the background of spinal deformity. 3
90,000 Osteoporosis of the spine – symptoms, diagnosis, treatment at the Central Clinical Hospital of the Russian Academy of Sciences
Osteoporosis is a chronic systemic, metabolic disease characterized by a decrease in bone mass and structural changes, leading to increased bone fragility and the risk of fractures.
This disease affects mainly the elderly, and more often elderly women. It is estimated that more than 200 million people suffer from osteoporosis in the world, of which 2.5 million have fractures.Moreover, 18% of women over 60 years old have some stage of compression fractures of the spine.
Osteoporosis develops gradually and is clinically revealed only after fractures, which is why it was called a “hidden epidemic”.
Clinical symptoms of osteoporosis consist of spinal deformity (kyphosis), decreased patient height, pathological bone fractures. Moreover, fractures of the vertebral bodies are one of the most common types of osteoporotic fractures.Fractures can be asymptomatic or painful. Patients often complain of “weakness in the back.”
In the presence of osteoporosis of the spine, the patient also experiences pain when palpating and tapping the spinal column. The dorsal muscles, as a rule, are significantly tense. Plus, this disease is characterized by clear changes in posture. It can be a stooped back, the so-called “supplicant pose”, as well as a “widow’s hump” or “a hump of elderly ladies.”Quite often, with osteoporosis of the spine, there is also an increase in the lumbar bend. On the sides of the abdomen, as a rule, small folds appear in the skin. Due to changes in the anatomical relationships of the spine and chest, the vital capacity of the lungs decreases and the work of the cardiovascular system is disrupted.
Diagnosis of osteoporosis should include conventional X-ray of the spine in two projections, computed tomography, possibly magnetic resonance imaging, determination of the level of alkaline phosphatase.
Carrying out functional treatment of vertebral body fractures in the elderly with osteoporosis is largely complicated due to the risk of hypodynamic complications; the use of fixation braces and orthoses in such patients is significantly limited due to their intolerance and the risk of exacerbation of cardiopulmonary insufficiency. Traditional surgical methods of treating vertebral fractures are associated with significant trauma and blood loss, which can be fatal for the body of an elderly person.
Among the methods of surgical treatment of uncomplicated vertebral body fractures in osteoporosis, it is necessary to highlight the technique of percutaneous vertebroplasty, developed and applied in France in 1984. Deramond EL, Depriester C, Galibert P., Le Gars B. This is a minimally invasive technology for the treatment of pain in the spine caused by various diseases affecting the vertebral body.
All manipulations are performed under X-ray control.
Indications for vertebroplasty are :
- Compression fractures associated with osteoporosis, both with pain syndrome and painless forms;
- tumor or metastatic lesions of the vertebral bodies;
- hemangioma of the vertebral body with its tendency to growth and the occurrence of pain;
- multiple myeloma.
The analgesic effect is associated with the elimination of the micromobility of the fragments, the thermal and chemical effect during polymerization, which causes dereception of nerve endings.After hardening, the bone cement restores the supporting function of the vertebra. This eliminates the need for traumatic surgery or long-term wearing of an uncomfortable corset. Correction of deformity and strengthening of the vertebra occurs due to the direct injection of cement into the vertebral body through a special needle, usually under local anesthesia.
Contraindications to the procedure :
- Hemorrhagic diathesis;
- Injury to the posterior wall of the vertebra makes the procedure dangerous due to the risk of leakage of cement into the spinal canal and compression of the spinal cord.
Manipulation is performed through a skin puncture. The patient can be discharged the very next day after surgery.
A new method of treating compression fractures associated with osteoporosis. A feature of this technique is that a balloon is inserted through a needle into the fractured vertebral body from both sides, and by symmetric injection of contrast fluid into this balloon, it is possible to partially or completely restore the lost height of the vertebral body.Then bone cement is injected into the formed cavity.
This operation is also performed through a skin puncture (that is, does not require surgical incisions) under local anesthesia. The duration of kyphoplasty is on average 30-60 minutes. After such an operation, the patient can be discharged from the hospital on the same day.
Kyphoplasty allows :
- Stop or significantly reduce back pain to prevent further “subsidence” of the broken vertebra, which helps to stop the progression of spinal deformity and related problems in the long term;
- restore the physiological curves of the spine and maintain normal posture.
Kyphoplasty should be considered as the operation of choice for the treatment of patients with back pain and vertebral deformity resulting from a pathological compression fracture.
Results of kyphoplasty surgery :
As a result of clinical studies, it has been shown that in 90% of patients with a compression fracture of the spine on the background of osteoporosis, back pain significantly decreases or disappears immediately or within 2 weeks after kyphoplasty.In 70-90% of patients, almost complete restoration of the normal height of the fractured vertebra body occurs.
General information about the disease
According to WHO experts, osteoporosis today is one of the most common diseases, along with myocardial infarction, cancer and sudden death, it occupies a leading place in the structure of morbidity and mortality. The social significance of osteoporosis of the spine is determined by its complications – fractures of the vertebral bodies, causing a high level of disability and mortality among the elderly and, accordingly, high material costs in health care.Among all fractures in persons of older age groups against the background of osteoporosis, vertebral fractures are from 20 to 30%.
There are several clinical variants of this disease. It is postmenopausal or postmenopausal osteoporosis that affects women during menopause. The disease here is associated with age-related involutive processes in the ovaries, with a decrease in the secretion of the hormone of the parathyroid glands and a deficiency in the body of the active metabolite of vitamin D3 – calcitriol, which largely regulates calcium metabolism.
Senile or cyanosis osteoporosis affects elderly people over 75-80 years old. A third of them are men. Asymptomatic, that is, as if invisible to the patient, spinal fractures are determined in every fourth case. In such patients, the level of calcitriol, a product of vitamin D3, is reduced, therefore, bone calcium metabolism is impaired. Here, too, a huge role is played by the deficiency of calcium, sunlight, limitation of physical activity, which contribute to the synthesis of vitamin D3 in the body.
At the same time, about 80% of patients, due to pain, sharply limit elementary everyday activities, they experience an exacerbation of chronic diseases, most of the victims need care, mortality increases significantly.
90,000 Spinal fractures – causes, symptoms, diagnosis and treatment
Fractures of the spine belong to the group of severe skeletal injuries and account for 2-2.5% of the total number of fractures.A combination of spinal fractures with damage to ligaments, muscles, intervertebral discs, roots, and spinal cord located in the immediate vicinity is possible. The clinical picture of spinal fractures depends on their location and on whether they are accompanied by spinal cord injury. The most life-threatening fractures are in the upper cervical spine, since trauma to the spinal cord in this section leads to a shutdown of the regulation of vital functions of the body. Diagnosis of spinal fractures includes X-ray examination, CT and MRI of the spine, electroneurography, etc.
Spinal fractures belong to the group of severe skeletal injuries and account for 2-2.5% of the total number of fractures. A combination of spinal fractures with damage to ligaments, muscles, intervertebral discs, roots, and spinal cord located in the immediate vicinity is possible.
Anatomy of the spine
The spine is the support and main part of the skeleton. It consists of individual bones (vertebrae) that are connected using continuous and discontinuous connections.Between each two adjacent vertebrae there are elastic intervertebral discs that act as shock absorbers during static (standing) and dynamic (walking, running, jumping) loads. The basis of the spinal column is made up of massive vertebral bodies. Behind each body, there is a vertebral arch in the form of a semicircle. The spinal cord is located in the space between the body and the vertebral arch. On each arch of the vertebra there are seven processes (four articular, two transverse and one spinous).
The articular processes of adjacent vertebrae are connected to form joints.In addition, the bodies, arches and processes of the vertebrae are connected by ligaments that give the spinal column the necessary strength and stability. Between two adjacent vertebrae there are openings for the exit of the roots of the spinal nerves. The spine is divided into 5 sections. The cervical section consists of 7 vertebrae, the thoracic – from 12, the lumbar – from 5, the sacral – from 5 (in this section, the vertebrae are fused into a single bone – the sacrum), the coccygeal – from 5 vertebrae.
The most common cause of a spinal fracture is a fall from a height (on the head, legs or buttocks).In the occurrence of fractures of the cervical spine, an inertial mechanism of injury (the so-called “whiplash”) plays an important role, which most often occurs in road traffic accidents: the car stops abruptly, the human body is held by a seat belt, while the head continues to move forward by inertia. As a result, the neck bends sharply and the vertebrae are crushed. Sometimes a similar injury causes a fracture of the thoracic vertebrae. In addition, spinal fractures can occur with compression and direct injury (impact on the neck or back).
All vertebral fractures are subdivided into vertebral fractures without or with spinal cord injury (spinal cord injury). Also, spinal fractures can be combined with damage to the intervertebral discs and nerve roots. There are isolated spinal fractures, in which one vertebra is damaged, and multiple fractures, in which two or more vertebrae are fractured. With multiple fractures, damage to adjacent vertebrae or vertebrae located at different levels of the spine is possible.
Distinguish between stable and unstable fractures of the spine. With unstable fractures, there is simultaneous damage to the anterior and posterior parts of the vertebra, as a result of which it becomes possible to displace the spine. With a stable fracture, either the posterior or the anterior parts of the vertebra are affected, so the spinal column remains stable. According to Russian traumatology, compression fractures of the spine are more often observed, in which, as a result of compression, the height of the vertebral body decreases.Less common are comminuted vertebral fractures.
Fractures of the cervical spine
The structure of the I and II cervical vertebrae differs from the structure of the rest of the vertebrae, therefore their fractures have some distinctive features.
Fractures of the first cervical vertebra
The first cervical vertebra is called atlanta, has a ring-shaped shape, located between the occipital bone and the rest of the vertebrae. There is no intervertebral disc between the occipital bone and the atlas, so the pressure from the cranium to the 1st cervical vertebra is transmitted without amortization.As a result of falling on the head, the occipital bone is pressed into the ring of the atlas and a Jefferson fracture occurs (“bursting fracture”), in which the integrity of the anterior and posterior arches of the 1st cervical vertebra is disrupted.
A patient with a fracture of the 1st cervical vertebra complains of pain in the occiput, parietal region and upper neck. In every second case, a fracture of the 1st cervical vertebra is accompanied by damage to the spinal cord, less often to the medulla oblongata or fracture of other vertebrae. Damage to the spinal cord is evidenced by impaired sensitivity and motor function of the upper and lower extremities (tetraplegia or tetraparesis).Damage to the medulla oblongata is fraught with disruption of the most important vital functions (respiration, heartbeat).
Fractures of the second cervical vertebra
The second cervical vertebra (axial vertebra or axis) is ring-shaped. In the front part of the axis there is a massive bony protrusion (axis tooth), on which the first cervical vertebra is fixed. A sharp bend of the neck leads to the fact that the atlas is excessively displaced backward or forward and breaks the axis tooth. The patient’s condition depends on the degree of displacement of the bone fragment of the tooth.With a fracture of the second cervical vertebra of the 1st degree, the displacement on the roentgenograms is not detected. The patient complains of mild pain when turning the head.
With II degree fractures of the second cervical vertebra, the fragment of the tooth is displaced anteriorly or posteriorly. Displacement of a fragment anteriorly can cause neurological disorders of varying severity: from local sensory disturbances to paresis and paralysis. When the tooth is displaced posteriorly, neurological disorders are usually less pronounced.Fractures of the second cervical vertebra of the third degree cause severe damage to the spinal cord and, as a rule, are incompatible with life.
Traumatic spondylolisthesis of the second cervical vertebra
Spondylolisthesis is the displacement of the overlying vertebra in relation to the underlying one. The vertebra can move backward, forward, or sideways. Such an injury occurs when the neck is suddenly extended in combination with a blow to the head against an obstacle (for example, in a car accident, when the passenger’s body is displaced forward and he hits his head against the windshield).
Usually, as a result of such an injury, a fracture of the arch of the second cervical vertebra occurs in combination with an anterior displacement of its body. The victim is worried about pain in the neck and back of the head, aggravated by movement. A characteristic symptom is the forced position of the head: the patient seems to “carry” his head, while often supporting it with his hands.
Fractures of the III-VII cervical vertebrae
As a rule, such fractures of the spine are the result of a sharp bending of the neck. Most often, there are compression fractures of the cervical vertebrae, less often – comminuted.In uncomplicated fractures, the patient complains of pain and limitation of movement in the neck. If a vertebral fracture is accompanied by a rupture of the ligaments, there is a threat of damage to the spinal cord.
Diagnosis of fractures of the cervical vertebrae
To confirm the fracture of the first cervical vertebra, radiographs are performed in special projections (pictures are taken through the mouth). In some cases, an additional CT scan of the spine is performed. If fractures of other cervical vertebrae are suspected, anteroposterior and lateral X-rays are taken.
First aid for fractures of the cervical spine
If such a fracture is suspected, it should be borne in mind that sudden movements can cause displacement of fragments and damage to the spinal cord, therefore, it is necessary to act extremely carefully and carefully. The patient is placed on his back on a stretcher. The neck is fixed with a special collar. The victim’s head must not be pulled or turned.
Treatment of fractures of the cervical spine
For uncomplicated spinal fractures, a Shants collar or a plaster corset is applied for up to 4 months.If there is a threat of displacement of fragments, traction is performed with a Glisson loop or apparatus traction behind the skull for up to 1 month, after which immobilization is performed with a rigid collar for up to 4 months. In severe injuries, fixation operations are performed using plates, laminar contractors and transarticular fixators.
Fractures of the thoracic and lumbar vertebrae
Compression fractures of the spine
The most common type of vertebral fractures.It occurs as a result of compression of the vertebra (when jumping from a height, falling on the buttocks). It is characterized by a decrease in the height of the vertebra. Compression fractures of the XI, XII thoracic and I lumbar vertebra are most often observed.
The risk of a compression fracture of the spine is increased with osteoporosis. In almost half of women over the age of 80, radiographs show signs of an old compression fracture of the vertebrae. At the same time, patients are injured during a minor fall and often do not go to a traumatologist, considering back pain a sign of age-related changes.
Pathological compression fractures of the spine often occur during metastasis of malignant tumors, when a vertebra destroyed by metastasis breaks as a result of minimal trauma.
Comminuted fractures of the spine
Less common. The most severe type of comminuted spinal fracture is an explosive fracture, in which the vertebral body splits into several fragments. Typically, these fractures are the result of a fall from a significant height, work or road traffic injury.
Symptoms of spinal fractures
With an uncomplicated spinal fracture (without spinal cord injury), the patient complains of back pain, aggravated by body movements. Visually, sometimes there is a smoothing of the contours of the spinal sulcus, slight edema or some bulge in the area of damage. The pain may worsen with deep breathing or coughing. Occasionally, with spinal fractures, abdominal pain radiates, simulating a picture of an “acute abdomen”.
Palpation of the spinous processes is painful, sometimes the expansion or narrowing of the gap between them is determined. A characteristic symptom of a spinal fracture is pain at the fracture site with gentle pressure on the patient’s head. You should not check this symptom on your own, since excessive pressure in an unstable vertebral fracture can cause displacement of the fragments.
Disorders of movement, sensation, or function of the pelvic organs indicate damage to the spinal cord.The cause of such a violation is usually comminuted vertebral fractures and, quite rarely, severe compression fractures of the spine, accompanied by a significant decrease in the height of the vertebra.
Compression fractures of the spine with a decrease in the height of the vertebra by 50% or more can subsequently be complicated by excessive mobility (segmental instability), which is manifested by persistent pain, rapid development of degenerative changes and damage to nerve structures.
Elderly patients may develop a “senile hump” – a characteristic deformity of the spine, which is also accompanied by chronic pain.
The most serious complication is rupture or compression of the roots or spinal cord. Tears of nerve structures appear at the time of injury. Compression can occur both at the time of damage and in a long-term period. In the latter case, neurological disorders are more often caused by compression of blood vessels and subsequent malnutrition of the spinal cord.The narrowing of the spinal canal leads to compression myelopathy, a progressive neurological disorder that can only be stopped with surgery.
The diagnosis is confirmed by anteroposterior and lateral radiographs. If an unstable fracture of the spine is suspected, CT (computed tomography) is done, which allows you to see both bone fractures and damage to soft tissue structures. MRI of the spine is used to diagnose damage to the roots and spinal cord.
CT scan of the thoracic and lumbar spine. Fracture of the transverse process of the 2nd and 3rd lumbar vertebrae without displacement.
For uncomplicated compression fractures, conservative therapy is indicated: pain relief in combination with fixation devices (corsets, reclinators) and a special regimen. The patient is placed on a shield with a roller under the damaged area. For 12-14 weeks, it is forbidden to lift weights, sit, bend forward and sharply turn the body.In some cases, a plaster corset is applied for up to 6 months.
Physiotherapy exercises are of great importance. Developed back muscles “take on” part of the load, thus relieving the load on the vertebrae and promoting their good fusion. For unstable spinal fractures, compression of the nerve roots and spinal cord, spinal surgeries are performed. Various fixators are used to stabilize the vertebrae, and if it is impossible to restore the vertebrae, implants made of artificial materials are used.
90,000 Compression fracture of the spine. Causes and treatment
In this injury, the vertebral body is compressed when it is pressed into the spinal canal. As a result, the nerve roots of the spinal cord are compressed, the intervertebral disc is destroyed, which causes the development of post-traumatic osteochondrosis and radiculitis. This can lead to permanent paralysis of the limbs.That is why, when discomfort in the body after a fall appears, it is necessary to consult a doctor, and if the patient cannot move, then he will need a hospice for bedridden patients. They will provide proper care here.
Compression fractures of the spine are usually caused by strong pressure on the vertebra. Most often, these fractures occur in the lower thoracic and lumbar spine. Most healthy bones can handle pressure normally, and the spinal column absorbs shock. A vertebral fracture can occur when jumping from a height to your feet.Compression fractures can be the result of a fall, a car accident, or any other load that exceeds the tensile strength of the spine. Another reason for compression fractures is weak vertebrae, which find it difficult to maintain normal loads. In this case, slight pressure may be required to destroy one of these vertebrae. This situation occurs in osteoporosis. According to some reports, osteoporosis is the most common cause of compression fractures. 40% of all women by the age of 80 had at least one compression fracture of the spine.
If the fracture is caused by sudden trauma, the first manifestation will be sharp pain in the spine, arms or legs. You can also feel weakness and numbness if the fracture damaged the nerve structures of the spinal column. If there is a slow destruction of the vertebra (as in osteoporosis), then a moderate, gradually increasing pain syndrome will be observed. If a fracture is suspected, the patient is examined by a neurologist. He prescribes an X-ray of the spine in two projections in order to understand which vertebra is and how much damaged.
It is also important to consult a doctor in order to exclude complicated forms of fracture, when neurological disorders or instability of the vertebrae appear. In this case, surgery may be necessary. Common treatments for compression fractures of the spine include pain management, activity limitation, and fixation. The doctor prescribes pain medications that do not accelerate fracture healing, but help control pain.In older people, bones take longer to heal than in younger people, and are generally thinner and weaker.
Always strictly follow the doctor’s recommendations, otherwise serious complications after the fracture may occur. For some types of compression fractures of the spine, it is possible to use orthopedic fixation braces. The corset is necessary for rigid fixation of the spine and limitation of movement. Usually corsets are made to order at prosthetic factories. This is necessary in order for the corset to exactly match the shape of the body.Holding the body in the correct position, the corset takes some of the load on itself, unloading the spinal column. This speeds up the fusion of the damaged vertebra.