Spine Fractures
The fracture of the spinal bones is usually caused by a very severe trauma. Since the spine is strong and well protected by the fibrous tissues that surround it, its fracture is only dependent on severe blows. Injuries to the spine can occur in automobile accidents, falls, when trying to move or lift a very heavy load, or during sudden jumps and jumps.
In general, the first complaint in patients with spinal fractures is pain. Neck, back or lower back pain may be accompanied by muscle spasms. If there is a spinal cord injury along with the fracture, there may be various complaints such as numbness, numbness in the arms and/or legs, loss of strength, urinary incontinence, incontinence, and inability to do so. If adequate treatment is not applied in patients who do not have nerve injury after the fracture, a humpback (kyphosis) in the spine and the severe pain it may cause may result in paralysis.
If the injury has caused an unstable fracture or fracture-dislocation, caused or has the risk of causing spinal cord damage, surgical methods are preferred for treatment. In surgical treatment, restoration of the integrity of the vertebrae is usually achieved with screws and rods applied from the back. The placement of these rods can also be performed with closed methods in suitable patients, thus minimizing postoperative pain and hospital stay. If there is a risk of nerve damage or injury, the relaxation process called decompression is added to the treatment during surgery.
Vertebroplasty or kyphoplasty method is preferred for compression fractures caused by osteoporosis. In the vertebroplasty method, bone cement is sent into the vertebrae to relieve pain while preventing the progression of collapse.
Compression Fractures
It occurs as a result of crushing the anterior region of the spine. It is seen in traumas that force the trunk to bend forward. Crush can occur in different sizes. “Seat Belt” injury, that is, compression fractures due to seat belts in vehicles should also be evaluated in this group; however, it should not be forgotten that soft tissues of the spine may also be damaged in such cases and should be evaluated separately.
Burst Fractures
They are usually seen as a result of falling from a height. It is possible to see spinal cord injury due to the fact that the resulting fracture fragments have the potential to move towards the spinal canal.
Fractured dislocations of the spine
It develops after very severe trauma. It is often associated with spinal cord injury.
Symptoms of a spinal fracture
Pain is usually the first symptom at the site of the fracture. Muscle spasm in the fracture area increases this pain. If there is a spinal cord injury, there may be numbness, weakness, numbness and loss of strength in the arms or legs, depending on the degree. Again, depending on the location and degree of the injury, complaints such as incontinence or inability to feel urine and stool may develop. In complete spinal cord injuries, complete paralysis can be seen covering the entire body region below the area where the injury occurred.
In untreated patients, kyphosis (humpback) may be seen and/or pain may develop in this region due to the fracture in the late period.
Diagnosis of spinal fracture
Definitive diagnosis is made by radiological examination. Again, the location and degree of the fracture is determined by radiological examination.
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direct radiography; indicates bone damage
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Computed tomography (CT, CT); shows the damage to the bone in more detail.
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magnetic resonance (MRI); It is used to evaluate the condition of the soft tissue and spinal cord at the fracture site.
Treatment of spinal fracture
The aim is to preserve the normal shape and integrity of the spine.
In the presence of a collapse of less than 50% of the vertebra; in seat belt type injuries without soft tissue injury; In burst type fractures that do not cause compression on the spinal cord and do not cause kyphosis, treatment is possible with the help of an extension type brace. In the acute period, rest and the use of painkillers are recommended.
If there is a collapse of more than 50% of the height of a vertebra; in seat belt type fractures with soft tissue injuries; burst type fractures that compress the spine or nerve roots; Surgical treatment is applied in fractured dislocations of the spine. In addition, surgical treatment is applied to patients with spinal cord injuries to facilitate rehabilitation.
Healing time of spinal fractures is 6-12 weeks.
instrumentation, fusion, decompression
Surgical treatment is applied in the form of fixing the fractured area using screws and rods connecting these screws, and welding the vertebrae in this area to each other by placing the bones. In some compression fractures, and especially in osteoporotic fractures, the height of the vertebrae is corrected as much as possible with the method called kyphoplasty and the resulting cavity is filled with bone cement. If the fracture creates pressure on the spinal cord, the bony ring behind the vertebra is removed and the spinal cord is released.