What Are Spinal Fractures?
The spine consists of 33spinal bones. A spinal fracture (vertebral fracture) may occur in any of these bones. However, 64% of spinal fractures occur in the spinal bones in the waist and back region. Spinal fractures are most common in the T12 and L1 spinal bones. Traffic accident, motorcycle accident, falls from height, firearm injuries, sports accidents andosteoporosiscan cause spinal fractures.
In such fractures, osteoporosis is of great importance. Especially in elderly patients, osteoporosis causes fracture due to the deterioration of the spongiosis structure in the spinal bones and loss of support. In cancers that involve the spine, the tumor located inside the spine may disrupt the bone structure and cause fracture. Fracture of the spinal bone can disrupt the patient's posture and cause pain.
What Are The Types of Spinal Fractures?
There are many different classifications of spinal fractures. Basically, fractures can be expressed as dislocations and fractured dislocations.
Fracture may occur as a result of the spinal bones being exposed to more load and pressure than they can withstand. The most common type of spinal fracture is a compression fracture known as a spinal collapse fracture.
It is mostly caused by conditions such as osteoporosis (bone loss) or tumors that cause the bones to weaken. In such fractures, the anterior part of the vertebra is broken and its height decreases, while the posterior part remains stable. This type of collapse fracture results in the shape of the vertebra not being square but wedge type. In this case, there is a deformity, that is, a hump, in which the spine, called kyphosis, bends forward.
In addition, a fracture may occur as a result of a vertical impact on the spine, such as falling on the feet from a very high place. In such traumas, the height of both the anterior and posterior regions of the vertebrae decreases. Such serious fractures that cause flattening of the spine can cause pressure on the spinal cord or nerve tissue.
As a result of excessive stretching or tearing in the ligaments and discs connecting the spinal bones, the spinal bones can slide out of their normal alignment. These dislocations may cause narrowing of the spinal canal and spinal cord damage.
Dislocations in the spine due to rupture in the ligaments with fracture in the vertebral bones are expressed as fractured dislocations. This type of traumatic injury usually requires surgical treatment.
What Are The Symptoms of Spinal Fractures?
Pain that suddenly appears in the waist and back area and intensifies as it moves is the most common of the symptoms of spinal fracture. If the broken bone compresses the spinal cord and nerves, there may be regional numbness as well as pain.
If the nerve roots or spinal cord are severely damaged due to pressure from the broken bone, sensation, reflex, muscle strength and movements may be affected. Nerve damage can also lead to problems such as loss of bladder and bowel control.
Symptoms of a spinal fracture usually include:
Waist, back or neck pain aggravated by movement,
Tingling, numbness or weakness in the limbs,
Intestinal and bladder problems,
Loss of movement in the arms and legs,
Loss of consciousness -fainting in severe fractures.
It is extremely important to seek emergency medical assistance, especially in severe cases of loss of consciousness and movement. Here, the person should be properly supported without being moved and the emergency aid team should be waited to come. It should be kept in mind that an unconscious movement can lead to spinal cord injury and paralysis.
What Are The Treatment Methods For Spinal Fractures?
In general, there are two treatment options for spinal fractures: surgical and non-surgical methods. Treatment options vary according to the type and severity of the fracture. Most vertebral fractures are collapse and burst fractures that occur in the anterior part of the vertebrae.Types of fractures and damage to the spinal cord are decisive for the treatment of spinal fractures.
Sedimentation fracture is mostly not used surgical method. It is recommended to use a corset and bed rest to prevent deformity that may occur. The aim here is to accelerate the healing process by limiting the movement of the spine. However, in cases where the fracture is much more severe; surgical method is used in burst fractures and fractured dislocations where the spinal cord is damaged or may be seen. In these cases, screw rods are generally preferred.
Corset or plaster treatment: A fixation is required for fractures to heal. Especially in patients with collapse fractures, spinal cord injury and soft tissue-bond tissue injury, corset or plaster treatment is preferred. The aim is to ensure the healing of the fracture by external detection and to prevent the spine from collapsing more and causing spinal cord compression and humping. The duration of the plaster or corset is usually 3 months.
Instrumentation and fusion: Detection of the broken spine using metal instruments and freezing at the same time. This process can be performed on the front or back of the spine, and sometimes it may need to be frozen on both sides. Fusion can take months.
At the same time, bone fragments compressing the spinal cord can be cleaned during surgical intervention in patients with spinal cord injury. It is the treatment method to be preferred in burst fractures where there is no neurological injury but the posterior connective tissues are injured and in all other burst fractures or fractured and fractured dislocations with neurological injury.
Vertebroplasty & Kyphoplasty: It is a minimally invasive treatment method that can be applied in some selected collapse fractures, osteoporosis or tumor-related fractures and some burst fractures. It can be applied under local anesthesia. It is based on the principle of entering the spine with large needles through small incisions to be made on the skin, correcting the fracture and placing titanium cage and/or cement to strengthen it.