The Vertebral fracture, also as Vertebral fracture known relates to damage to the plate-shaped part of the vertebra. This part of the vertebra located inside the body can be injured due to illness or through trauma, such as an accident. The vertebral body fracture is painful and, depending on the type or strength, injuries to the spinal cord, ligaments and tendons are possible.
What is a vertebral fracture?
A Vertebral fracture exclusively affects the disc-shaped vertebral body, which is also the contact surface of the intervertebral discs. The vertebral body fracture itself is divided into different types, which describe the type of fracture.
The classification in fractures of the A-type, B-type and C-type also indicates the type of force that caused the vertebral body fracture. A distinction is made between compression fractures, which are caused by compression of the vertebrae, and are referred to as A fractures.
Distraction fractures result in hyperextension forwards or backwards, while rotational fractures result from twisting the spine. These C-type rotational fractures are among the most severe forms of vertebral body fractures, as fractures of the rest of the vertebra often occur with this cause.
causes
The Vertebral fracture is in many cases the result of a sports injury or an accident. The excessive stress and force on the spine exposes the vertebral body to forces that lead to a vertebral body fracture.
In these cases, the intervertebral discs are insufficient to protect the bony vertebral body and to cushion the pressure suddenly acting on the structure in different places. In addition to vertebral body fractures in healthy patients, vertebral body fractures are also possible for reasons of illness. Older people who also suffer from a disease that weakens the bone structure are particularly often affected.
If there is osteoporosis, a vertebral body fracture can occur without noticeable force exerted on the bone. Some cancers also affect the stability of the bones and lead to a fracture of the vertebral body even with normal movement.
Typical symptoms & signs
- Back pain
- Movement restrictions in the area of the cervical spine
- Constrained posture or misalignment of the head
- Bruising
- Sensory disturbances
- paralysis
- Muscle weakness
Diagnosis & course
The Vertebral fracture manifests itself as a severe pain in the back. After an accident, this is always an indicator to consult a doctor for a closer examination. Patients with a known bone disease should also clarify the cause of new back pain with their treating doctor. This will examine the spine for damage in the imaging process and usually determine the vertebral body fracture on the X-ray image.
Even a fracture of the vertebral body, which is initially only painful, can cause sensory disturbances, paralysis of the extremities and permanent pain. Incontinence and intestinal paralysis are also possible symptoms and consequences of vertebral body fractures. If the vertebral body fracture heals, a narrowing of the vertebral canal due to the change in the surface along the fracture points is realistic as a long-term consequence.
Complications
The complications associated with a vertebral fracture may depend on the type and complexity of the fracture and whether or not treatment was performed. Most vertebral body fractures, if recognized and treated in good time, can heal without major consequential damage, although possible causes must be considered.
The most serious complication in this context is paraplegia, which can be caused by pinching and injuring the spinal cord. This occurs especially in the case of severely displaced fragments of the vertebral bodies or when individual vertebral bodies collapse (mostly in connection with osteoporosis). But partial paralysis can also occur, depending on the height of the broken vertebra.
For example, the arms, legs, or bowel and bladder emptying can be affected. Damage to the spinal cord can also lead to breathing problems and neurological disorders.This includes failures of conscious perception, emotional disorders and the inability to use one's own body parts in a targeted manner.
If a vertebral body is broken in such a way that its structure is permanently damaged, the back may become inclined (hump formation), body size reduction and chronic pain. The surgical procedures for treating a vertebral body fracture can, depending on the location and fracture, involve a risk of complications, which is primarily related to possible injuries to the spinal cord.
When should you go to the doctor?
If there is pain in the back after vigorous physical activity, an accident, fall or violence, action is often required. First of all, the person affected should check whether the symptoms regress after sufficient rest and rest. If symptoms are free after a few hours or a restful night's sleep, in most cases no doctor is required.
However, if the health irregularities persist or if they increase in scope and intensity, a doctor's visit is advisable. Pain in the back area, restricted mobility or disturbances in general movement sequences must be examined and treated. If the person concerned suffers from symptoms of paralysis, there is an acute need for action.
In particularly severe cases, an ambulance service should be contacted. In order to avoid consequential damage, the instructions of the rescue team must be followed. If there is a sudden decrease in physical performance, skin changes or bruises develop, a doctor is needed.
These are signs of a health disorder that must be clarified and, if necessary, treated. If the person concerned takes a relieving posture due to the symptoms, a doctor should be consulted. There is a risk of long-term damage and in some cases, action must be taken as quickly as possible so that long-term relief of the irregularities is achieved. Otherwise, some diseases can lead to lifelong impairments.
Treatment & Therapy
The Vertebral fracture is treated conservatively or surgically depending on the type and severity. In the event of a fracture caused by an accident, it is important to stabilize the patient until the diagnosis is more precise in order to prevent further damage to the vertebrae and the spinal cord.
If the examination shows that the fracture can be treated with further stabilization, the patient has to go through the healing phase with good pain therapy in relative calm, but not in immobility. Triggering diseases such as osteoporosis are treated in combination therapy in order to effectively combat the causes. Vertebral body fractures in the area of the thoracic spine are adequately supported by the thorax itself and additional supports can usually be dispensed with.
Surgical intervention is only necessary if there is a risk that the spinal cord will be damaged or even more impaired by the vertebral fracture. The surgeon's goal is to stabilize the vertebral body fracture again with various means such as plates, screws or the body's own bone material. The pressure is removed from the spinal cord when correcting the vertebral body fracture and the resulting change in position of the spine is corrected as completely as possible.
prevention
A Vertebral fracture can at least be avoided if emphasis is placed on good equipment and correctly learned movement in sports that are prone to accidents. Disease-related vertebral body fractures, on the other hand, can be avoided by treating the underlying disease early and carefully. In this way, the impairment of the bone structure can be stopped or at least slowed down and a vertebral body fracture fended off.
Aftercare
If the vertebral body fracture occurs as part of osteoporosis, the alleviation of the underlying disease is of great importance in follow-up care. The administration of special medications can influence the calcium metabolism and improve bone density. Physiotherapy can help relieve pain and specifically build and strengthen the back muscles: This relieves the spine and minimizes the risk of a new fracture.
In the case of vertebral body fractures after accidents that require surgical treatment, the operation should be followed by rehabilitation immediately. Often, light physiotherapeutic exercises can be started one day after the operation. With the help of targeted movements, the spine should be mobilized and normal mobility restored.
Whether this can be fully achieved depends on whether and to what extent neurological deficits are present. For people of working age, re-entry into working life is the top priority: Professions with low to medium physical strain can usually be exercised again after a rehabilitation phase of two to three months.
For patients with a physically difficult job, retraining to a less physically demanding job often turns out to be sensible. In the case of vertebral body fractures that result in paralysis, the main focus is on establishing independence through physiotherapy and useful aids.
You can do that yourself
In the event of disorders of the skeletal system, the general movement sequences in everyday life must be checked and optimized at regular intervals. One-sided or rigid postures can lead to an increase in symptoms. Therefore they are to be avoided if possible or compensatory movements should be carried out. When lifting and carrying objects, make sure that they are only light. All physical movements should be performed slowly and with increased awareness in the recovery process. Jerky movements, jumping or running interfere with healing and can lead to complications. Therefore, sporting activities or the performance of professional activities should be avoided.
In everyday life, it is advisable to seek help and support from relatives or people in your close social environment in fulfilling your daily duties. Physiotherapeutic training units can also be carried out independently outside of therapy. These help to cope with everyday life and at the same time promote the healing process. Drafts have an adverse effect on a vertebral fracture. Therefore, the affected area should be adequately protected. Heat supply alleviates any existing discomfort.
The dead weight must also be checked. If you are overweight, problems can occur and the symptoms can increase. Therefore, a change in diet and weight reduction may have to take place in order to achieve a long-term recovery.
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