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» Fractures of the thoracic and lumbar vertebrae
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Fractures of the thoracic and lumbar vertebrae
The most common fractures of vertebral bodies. Typically, compression fractures of vertebrae and perelomovyvihi are uncomplicated. Broken bodies of the vertebrae in their places of greatest stress in transition from breast to the lumbar spine. These fractures occur when falling from a height on the buttocks or legs straight or bent sharp spine.
Patients complain of back pain, lower back, which is intensified by movement. The pain occurs in the damaged vertebra and stronger just after injury, and decreases with time and sometimes it becomes undistinguished. Sometimes patients forget about the trauma and lead a normal life: they go and sit. The pain intensified in the sitting position, especially when riding in a car, bike and disappear in the supine position, the spine is not loaded. On examination revealed deformation of the spinous processes of the spine, scoliosis, increased thoracic curvature of the spine.
Spinous process of the affected vertebrae may bulge. Usually it is painful when pressed. The muscles along the spine of the affected are in a state of tension. Some patients may occur violation of urination, pain in the abdomen.
When spinal cord injury patient revealed a variety of neurological disorders. Possible concussion spinal cord spinal cord contusion, the lunch break, spinal cord compression, bleeding in the spinal cord, or under its shell. Spinal concussion is manifested sensory disturbances, muscle weakness innervated by the spinal cord below the injury site. Violations of the bowel and bladder are non-durable. Usually, all the manifestations of spinal cord concussion pass for the week.
Spinal cord contusion. When a spinal cord contusion injury occurs substance of the brain, its cells and agents. In the field of damage small blood vessels formed small hemorrhages and strokes. But immediately after the injury occurs spinal shock, which can manifest complete paralysis of limbs below the injury, disappearance of sensitivity, urinary retention and fecal incontinence. With full suspension of spinal cord recovery of lost functions does not, form sores and other complications. Spinal cord compression can occur simultaneously in the time of injury. In this case it is called acute.
Symptoms are caused compression in the first hours or days after injury show early spinal cord compression. But even after months or years after a spinal injury may be signs of spinal cord compression. This occurs due to excessive formation of callus at the site of injury, adhesive and degenerative processes in the area of damage.
Fractures of vertebrae, especially involving the displacement of bone fragments, the formation of traumatic herniated discs often have compression of the spinal roots, which take place in the intervertebral foramen. This is manifested symptoms of sciatica in the affected nerve root.
The diagnosis of a fracture of thoracic and lumbar vertebrae install X-ray examination. Wedge deformation detected a broken vertebra.
In the first-degree compression fracture of vertebral body height is reduced by one third in the second degree - up to 60%.
The third level compression fracture set at lower height vertebra more than 60%. To clarify the location and nature of the fracture is carried out CT scans.
Treatment of fractures of the thoracic and lumbar vertebrae
If you suspect a fracture of the spine patient is carefully packed on a stretcher, under your knees enclose a large roll of blankets or clothes and immediately transported to the hospital. In uncomplicated fractures of the vertebrae using conservative treatment.
Reposition the vertebrae called reclination. Reclination carried out on an orthopedic table method pererazgibaniya. If possible, spend one-stage reclination. After this is applied a plaster corset. Gradual reclination carried out at risk of complications. It is performed by means of rollers of different sizes, placed under the patient's back to the site of injury. The height of the roller is gradually increased. Under the influence of straightening the spine damaged vertebra gradually regains its shape.
Gradual reclination produce about two months. After that impose rigid brace for up to 6 months, sometimes more. Necessarily assigned to physiotherapy and therapeutic exercise.
In complicated fractures of the vertebrae, with compression of the spinal cord, with comminuted fractures of the surgical treatment is carried out. Produce a temporary fixation of the spine to unload the damaged vertebra and create conditions for the seam. Use special clips of various systems. If it is impossible to restore the structure of the vertebral used implantation of artificial materials.
