ICD codes: S00-T98. Consequences of intracranial injury Consequences of trauma ICD 10 code

RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)
Version: Archive - Clinical protocols of the Ministry of Health of the Republic of Kazakhstan - 2010 (Order No. 239)

Consequences of intracranial trauma (T90.5)

general information

Short description

Traumatic brain injury(TBI) is a brain injury of varying degrees in which trauma is the etiological factor. Traumatic brain injury in childhood is a common and severe type of traumatic injury and accounts for 25-45% of all cases of traumatic injury.

The incidence of traumatic brain injuries has increased significantly in recent years due to an increase in the frequency of motor vehicle accidents. The clinical picture is influenced by the anatomical and physiological features of incomplete brain ontogenesis, the mechanism of injury, premorbid features of the nervous system, and cerebrovascular complications. Unlike adults, in children, especially young children, the degree of depression of consciousness often does not correspond to the severity of brain damage. Concussions and mild and moderate brain contusions in children can often occur without loss of consciousness, and mild and moderate brain contusions can occur without focal neurological symptoms or with minimal severity.

Protocol"Consequences of intracranial injury"

ICD-10 code: T 90.5

Classification

Open traumatic brain injury

Characteristically, there are injuries to the soft tissues of the head with damage to the aponeurosis or a fracture of the bones of the base of the skull, accompanied by leakage of cerebrospinal fluid from the nose or ear.

1. Penetrating traumatic brain injury, in which there is damage to the dura mater.

2. Non-penetrating traumatic brain injury:

3. Closed craniocerebral injury - the integrity of the head is not broken.

According to the nature and severity of brain damage:

Concussion - commotion cerebri, in which there are no obvious morphological changes;

Brain contusion - contusion cerebri, (mild, moderate and severe);

Diffuse axonal damage.

Brain compression- compressio cerebri:

1. Epidural hematoma.

2. Subdural hematoma.

3. Intracerebral hematoma.

4. Depressed fracture.

5. Subdural hydroma.

6. Pneumocephaly.

7. The focus of the injury is a crushed brain.

Consequences of severe traumatic brain injury:

1. Traumatic cerebroasthenia syndrome.

2. Traumatic hypertensive-hydrocephalic syndrome.

3. Syndrome of movement disorders in the form of paresis and paralysis of the limbs.

4. Traumatic epilepsy.

5. Neurosis-like disorders.

6. Psychopathic-like states.

Diagnostics

Diagnostic criteria

Brain concussion. Classic symptoms of a concussion include loss of consciousness, vomiting, headache, and retrograde amnesia. Frequent symptoms are nystagmus, lethargy, adynamia, and drowsiness. There were no symptoms of local brain damage, changes in cerebrospinal fluid pressure, or congestion in the fundus.

Brain contusion. Clinical symptoms consist of general cerebral and focal disorders. In typical cases of brain contusion, pallor, headache, especially in the area of ​​the contusion, repeated vomiting, bradycardia, respiratory arrhythmia, decreased blood pressure, stiff neck, and a positive Kernig sign are observed in the first days. Meningeal symptoms are caused by swelling and blood in the subarachnoid space. The cerebrospinal fluid often contains blood. The blood temperature increases significantly after 1-2 days, when toxicosis develops and leukocytosis increases in the blood with a shift to the left.

The most common focal symptoms of a bruise are mono- and hemiparesis, sensory disturbances of the hemi- and pseudoperipheral type, impaired visual fields, and various types of speech disorders. Muscle tone in the affected limbs, reduced in the first days after the injury, subsequently increases in a spastic manner and has signs of pyramidal lesions.

Damage to the cranial nerves is not typical for brain contusion. Damage to the oculomotor, facial and auditory nerves makes one think of a fracture of the base of the skull. Some time after a brain injury, traumatic epilepsy may develop with general convulsive or focal seizures, after which mental disorders, aggressiveness, depression, and mood disorders develop. At school age, vegetative changes, lack of attention, increased fatigue, and mood lability predominate.

Brain compression. The most common causes of brain compression are intracranial hematomas and depressed skull fractures, while edema - swelling of the brain - plays a lesser role. Traumatic hemorrhages are epidural, subdural, subarachnoid, parenchymal and ventricular. For brain compression, it is very typical that there is a clear gap between the injury and the appearance of the first symptoms of compression, which then intensify quite quickly.

Epidural hematoma. Hemorrhage between the dura mater and the bones of the skull at the site of the fracture most often occurs in the vault area. The most important symptom of a hematoma is anisocoria with pupil dilation on the side of the hematoma. Focal symptoms of brain damage are caused by the location of the hematoma. The most common symptoms of irritation are focal (Jacksonian) epileptic seizures and prolapse symptoms, pyramidal in the form of mono-, hemiparesis or paralysis on the side opposite the dilated pupil. Repeated loss of consciousness is of important diagnostic significance. If an epidural hematoma is suspected, surgery is indicated.

Subdural hematoma- This is a massive accumulation of blood in the subdural space. With a subdural hematoma, a light interval is noted, but it is longer. Focal symptoms of brain compression develop in combination with general cerebral disorders. Meningeal signs are characteristic. A persistent symptom is persistent headache accompanied by nausea and vomiting, indicating hypertension. Jacksonian seizures often develop. Patients are often agitated and disoriented.

Complaints and anamnesis
Complaints of frequent headaches, which are localized more often in the forehead and back of the head, less often in the temporal and parietal areas, are accompanied by nausea and sometimes vomiting, which brings relief, dizziness, weakness, fatigue, irritability, disturbed, restless sleep. Weather dependence, emotional lability, decreased memory and attention. There may be complaints of seizures, limited joint movements, weakness in them, impaired gait, and delayed psycho-speech development. History of traumatic brain injury.

Physical examination: a study of the psycho-emotional sphere, neurological status, and autonomic nervous system reveals functional disorders of the nervous system, emotional lability, and the phenomena of cerebroasthenia.
Motor disorders - paresis, paralysis, contractures and stiffness in the joints, hyperkinesis, delayed psycho-speech development, epileptic seizures, pathology of the visual organs (strabismus, nystagmus, optic nerve atrophy), microcephaly or hydrocephalus.

Laboratory research:

3. Biochemical blood test.

Instrumental studies:

1. X-ray of the skull - prescribed to exclude skull fractures.

2. EMG - according to indications, allows you to identify the degree of damage occurring in myoneural endings and muscle fibers. In cases of traumatic brain injury, type 1 EMG is most often observed, which reflects the pathology of the central motor neuron and is characterized by increased synergistic activity of voluntary contraction.

3. Doppler ultrasound of cerebral vessels to exclude vascular pathology of the brain.

4. Neurosonography - to exclude intracranial hypertension, hydrocephalus.

5. CT or MRI as indicated to exclude organic brain damage.

6. EEG for traumatic brain injury. The post-traumatic period is characterized by further progression of vegetative, emotional and intellectual mental disorders, which exclude full-fledged work activity for many victims.
The dynamism, mildness of focal symptoms, and the predominance of cerebral generalized reactions characteristic of children serve as a reason in determining the severity of the injury that accompanies its complication.

EEG for concussion: mild or moderate changes in biopotentials in the form of disorganization of the α rhythm, the presence of mild pathological activity and EEG signs of dysfunction of brain stem structures.

EEG for brain contusions: The EEG records cortical rhythm disturbances and gross cerebral disturbances in the form of dominance of slow waves. Sometimes sharp potentials, diffuse peaks, and positive spikes appear on the EEG. Steadily expressed diffuse β waves, which are combined with bursts of high-amplitude θ oscillations.

School-age children are more likely to experience moderate EEG changes. Against the background of an uneven amplitude, but stable rhythm, mild θ and β activity is detected. In half of the cases, individual sharp waves, asynchronous and synchronized β oscillations, bilateral β waves and sharp potentials in the posterior hemispheres appear on the EEG.

EEG in severe traumatic brain injury: In the acute period of severe TBI, gross EEG disturbances are most often recorded in the form of dominance of slow forms of activity in all parts of the hemispheres. In most patients, the EEG shows signs of dysfunction of the basal-diencephalic structures and focal manifestations.

Indications for specialist consultations:

1. Oculist.

2. Speech therapist.

3. Orthopedist.

4. Psychologist.

5. Prosthetist.

7. Audiologist.

8. Neurosurgeon.

Minimum examinations when referred to a hospital:

1. General blood test.

2. General urine analysis.

3. Feces on worm eggs.

Basic diagnostic measures:

1. General blood test.

2. General urine analysis.

3. CT or MRI of the brain.

4. Neurosonography.

5. Speech therapist.

6. Psychologist.

7. Oculist.

8. Orthopedist.

11. Physical therapy doctor.

12. Physiotherapist.

List of additional diagnostic measures:

1. Prosthetist.

3. Cardiologist.

4. Ultrasound of the abdominal organs.

5. Gastroenterologist.

6. Endocrinologist.

Differential diagnosis

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Treatment

Treatment tactics
Treatment of traumatic brain injuries must be comprehensive. Angioprotectors are used to improve cerebral circulation, neuroprotectors to improve the delivery of oxygen to the brain, nutrition of the brain, and improvement of metabolic processes in the brain. Dehydration therapy is used to reduce and relieve cerebral edema, sedative therapy aimed at eliminating neuropsychiatric disorders and normalizing sleep. Anticonvulsant therapy is prescribed to stop symptomatic seizures. Vitamin therapy to strengthen the general condition of the patient.

Goal of treatment: reduction of cerebral symptoms, improvement of emotional background, reduction of weather dependence, elimination of neuropsychic disorders, normalization of sleep, strengthening of the general condition of the patient. Stopping or reducing seizures, improving motor and psycho-speech activity, preventing pathological postures and contractures, acquiring self-care skills and social adaptation.

Non-drug treatment:

1. Massage.

3. Physiotherapy.

4. Conductive pedagogy.

5. Classes with a speech therapist.

6. With a psychologist.

7. Acupuncture.

Drug treatment:

1. Neuroprotectors: cerebrolysin, actovegin, piracetam, pyritinol, ginkgo biloba, hopantenic acid, glycine.

2. Angioprotectors: vinpocetine, instenon, sermion, cinnarizine.

3. B vitamins: thiamine bromide, pyridoxine hydrochloride, cyanocobalamin, folic acid.

4. Dehydration therapy: magnesia, diacarb, furosemide.

List of essential medications:

1. Actovegin ampoules 80 mg 2 ml

2. Vinpocetine (Cavinton), tablets 5 mg

3. Glycine tablets 0.1

4. Instenon ampoules and tablets

5. Nicergoline (Sermion) ampoules 1 bottle 4 mg, tablets 5 mg, 10 mg

6. Pantocalcin, tablets 0.25

7. Piracetam, tablets 0.2

8. Piracetam, ampoules 20% 5 ml

9. Pyridoxine hydrochloride ampoules 1 ml 5%

10. Folic acid, tablets 0.001

11. Cerebrolysin ampoules 1 ml

12. Cyanocobalamin, ampoules of 200 and 500 mcg

Additional medications:

1. Aevit, capsules

2. Asparkam, tablets

3. Acetazolamide (diacarb), tablets 0.25

4. Gingko-Biloba tablets, 40 mg tablets

5. Gliatilin in ampoules 1000 mg

6. Gliatilin capsules 400 mg

7. Hopanthenic acid, tablets 0.25 mg

8. Depakine, tablets 300 mg and 500 mg

9. Dibazol, tablets 0.02

10. Carbamazepine, tablets 200 mg

11. Konvulex capsules 300 mg, solution

12. Lamotrigine (Lamictal, Lamitor), tablets 25 mg

13. Lucetam tablets 0.4 and ampoules

14. Magne B6 tablets

15. Neuromidin tablets

16. Pyritinol (Encephabol), tablets 100 mg, suspension 200 ml

17. Prednisolone in ampoules 30 mg

18. Prednisolone tablets 5 mg

19. Thiamine chloride ampoules 1 ml

20. Tizanidine (Sirdalud), tablets 2 mg and 4 mg

21. Tolperisone hydrochloride (Mydocalm), tablets 50 mg

22. Topamax, tablets, capsules 15 mg and 25 mg

23. Furosemide, tablets 40 mg

Indicators of treatment effectiveness:

1. Reduction of general cerebral syndrome, emotional and volitional disorders.

2. Improving attention and memory.

3. Stopping or reducing seizures.

4. Increase in the volume of active and passive movements in paretic limbs.

5. Improvement of motor and psycho-speech activity.

6. Improved muscle tone.

7. Acquiring self-care skills.

Hospitalization

Indications for hospitalization (planned): frequent headaches, dizziness, weather dependence, emotional lability, symptoms of cerebroasthenia, seizures, motor disorders - the presence of paresis, gait disturbance, delayed psycho-speech and motor development, decreased memory and attention, behavioral disturbances.

Information

Sources and literature

1. Protocols for diagnosis and treatment of diseases of the Ministry of Health of the Republic of Kazakhstan (Order No. 239 of 04/07/2010)
   1. 1. L. O. Badalyan. Child neurology. Moscow 1998 2. A. Yu. Petrukhin. Child neurology. Moscow 2004 3. M. B. Zucker. Clinical neuropathology of childhood. Moscow1996 4. Diagnosis and treatment of diseases of the nervous system in children. Edited by V. P. Zykov. Moscow 2006

Information

List of developers:

Attached files

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Diagnosis with code S00-T98 includes 21 qualifying diagnoses (ICD-10 headings):

1. S00-S09 - Head injuries
   Included: injuries: . ear. eyes. face (any part). gums. jaws. areas of the temporomandibular joint. oral cavity. sky. periocular area. scalp. language. tooth
2. S10-S19 – Neck injuries
   Contains 10 blocks of diagnoses.
   Included: injuries: . back of the neck. supraclavicular region. throat.
3. S20-S29 – Chest injuries
   Contains 10 blocks of diagnoses.
   Included: injuries: . mammary gland. chest (walls). interscapular region.
4. S30-S39 – Injuries to the abdomen, lower back, lumbar spine and pelvis
   Contains 10 blocks of diagnoses.
   Included: injuries: . abdominal wall. anus. gluteal region. external genitalia. side of the abdomen. groin area.
5. S40-S49 – Injuries of the shoulder girdle and shoulder
   Contains 10 blocks of diagnoses.
   Included: injuries: . armpit. scapular region.
6. S50-S59 – Elbow and forearm injuries
   Contains 10 blocks of diagnoses.
   Excluded: bilateral injury to the elbow and forearm (T00-T07) thermal and chemical burns (T20-T32) frostbite (T33-T35) injuries: . hands at unspecified level (T10-T11). wrists and hands (S60-S69) bite or sting of a poisonous insect (T63.4).
7. S60-S69 – Wrist and hand injuries
   Contains 10 blocks of diagnoses.
   Excluded: bilateral wrist and hand injuries (T00-T07) thermal and chemical burns (T20-T32) frostbite (T33-T35) hand injuries at an unspecified level (T10-T11) bite or sting of a poisonous insect (T63.4).
8. S70-S79 - Injuries of the hip joint and thigh
   Contains 10 blocks of diagnoses.
   Excluded: bilateral hip and thigh injuries (T00-T07) thermal and chemical burns (T20-T32) frostbite (T33-T35) leg injuries at an unspecified level (T12-T13) poisonous insect bite or sting (T63.4).
9. S80-S89 – Knee and lower leg injuries
   Contains 10 blocks of diagnoses.
   Included: fracture of the ankle and ankle.
10. S90-S99 – Injuries to the ankle and foot area
    Contains 10 blocks of diagnoses.
    Excluded: bilateral injury to the ankle and foot (T00-T07) thermal and chemical burns and corrosion (T20-T32) fracture of the ankle and ankle (S82.-) frostbite (T33-T35) injuries of the lower extremity at an unspecified level (T12- T13) bite or sting of a poisonous insect (T63.4).
11. T00-T07 - Injuries involving multiple areas of the body
    Contains 8 blocks of diagnoses.
    Included: bilateral extremity injuries with equal levels of injury involving two or more areas of the body, classified in categories S00-S99.
12. T08-T14 - Injury to an unspecified part of the trunk, limb or area of ​​the body
    Contains 7 blocks of diagnoses.
    Excluded: thermal and chemical burns (T20-T32) frostbite (T33-T35) injuries involving several areas of the body (T00-T07) bite or sting of a poisonous insect (T63.4).
13. T15-T19 - Consequences of foreign body penetration through natural orifices
    Contains 5 blocks of diagnoses.
    Excluded: foreign body: . accidentally left in a surgical wound (T81.5) . in a puncture wound - see open wound by area of ​​the body. unsuccessful in soft tissue (M79.5). splinter (splinter) without a large open wound - see superficial wound by area of ​​the body.
14. T20-T32 - Thermal and chemical burns
    Contains 3 blocks of diagnoses.
    Includes: burns (thermal) caused by: . electric heating devices. electric shock. flame. friction. hot air and hot gases. hot objects. lightning. radiation chemical burns [corrosion] (external) (internal) scalding.
15. T33-T35 - Frostbite
    Contains 3 blocks of diagnoses.
    Excludes: hypothermia and other effects of exposure to low temperatures (T68-T69).
16. T36-T50 - Poisoning by drugs, medications and biological substances
    Included: cases: . overdose of these substances. improper dispensing or mistaken administration of these substances.
17. T51-T65 - Toxic effects of substances, mainly for non-medical purposes
    Contains 15 diagnosis blocks.
    Excluded: chemical burns (T20-T32) local toxic effects classified elsewhere (A00-R99) respiratory disorders due to exposure to external agents (J60-J70).
18. T66-T78 - Other and unspecified effects of external causes
    Contains 10 blocks of diagnoses.
19. T79-T79 - Some early complications of injuries
    Contains 1 block of diagnoses.
20. T80-T88 - Complications of surgical and therapeutic interventions, not elsewhere classified
    Contains 9 blocks of diagnoses.
21. T90-T98 - Consequences of injuries, poisoning and other effects of external causes
    Contains 9 blocks of diagnoses.

Chain in classification:

1
2 S00-T98 Injuries, poisoning and some other consequences of external causes

The diagnosis does not include:
- birth trauma (P10-P15)
- obstetric trauma (O70-O71)

Explanation of the disease with code S00-T98 in the MBK-10 directory:

In this class, the section designated S is used to code various types of injuries related to a specific area of ​​the body, and the section designated T is used to code multiple injuries and injuries to individual unspecified body parts, as well as poisoning and some other consequences of exposure external reasons.

In cases where the heading indicates the multiple nature of the injury, the conjunction “c” means simultaneous damage to both named areas of the body, and the conjunction “and” means both one and both areas.

The principle of multiple injury coding should be applied as widely as possible. Combined rubrics for multiple injuries are given for use when there is insufficient detail of the nature of each individual injury or for primary statistical developments, when it is more convenient to register a single code; in other cases, each component of the injury should be coded separately. In addition, it is necessary to take into account the rules for coding morbidity and mortality set out in Volume 2.

The blocks of section S, as well as the headings T00-T14 and T90-T98, include injuries that, at the level of three-digit headings, are classified by type as follows:

Superficial trauma, including:
abrasion
water bubble (non-thermal)
contusion, including bruising, bruising and hematoma
trauma from a superficial foreign body (splinter) without a large open wound
insect bite (non-venomous)
Open wound, including:
bitten
sliced
torn
chopped:
. NOS
. with (penetrating) foreign body

Fracture, including:
. closed: . splintered). depressed). speaker). split). incomplete). impacted) with or without delayed healing. linear). marching). simple ) . with displacement) of the epiphysis). helical
. with dislocation
. with offset

Fracture:
. open: . difficult ) . infected). gunshot) with or without delayed healing. with a pinpoint wound). with a foreign body)
Excluded: fracture: . pathological (M84.4) . with osteoporosis (M80.-) . stress (M84.3) malunion (M84.0) nonunion [false joint] (M84.1)

Dislocations, sprains and overstrain of the capsular-ligamentous apparatus of the joint, including:
separation)
gap)
stretch)
overvoltage)
traumatic: ) joint (capsule) ligament
. hemarthrosis)
. tear)
. subluxation)
. gap)

Nerve and spinal cord injury, including:
complete or incomplete spinal cord injury
disruption of the integrity of nerves and spinal cord
traumatic:
. nerve transection
. hematomyelia
. paralysis (transient)
. paraplegia
. quadriplegia

Damage to blood vessels, including:
separation)
dissection)
tear)
traumatic: ) blood vessels
. aneurysm or fistula (arteriovenous)
. arterial hematoma)
. gap)

Damage to muscles and tendons, including:
separation)
dissection)
tear) muscles and tendons
traumatic rupture)

Crushing [crushing]
Traumatic amputation
Internal organ injury, including:
from a blast wave)
bruise)
concussion injuries)
crushing)
dissection)
traumatic (s): ) internal organs
. hematoma)
. puncture)
. gap)
. tear)
Other and unspecified injuries

This class contains the following blocks:

• S00-S09 Head injuries
• S10-S19 Neck injuries
• S20-S29 Chest injuries
• S30-S39 Injuries to the abdomen, lower back, lumbar spine and pelvis
• S40-S49 Injuries of the shoulder girdle and shoulder
• S50-S59 Elbow and forearm injuries
• S60-S69 Wrist and hand injuries
• S70-S79 Injuries of the hip joint and thigh
• S80-S89 Knee and lower leg injuries
• S90-S99 Injuries to the ankle and foot area
• T00-T07 Injuries involving multiple areas of the body
• T08-T14 Injury to an unspecified part of the trunk, limb or area of ​​the body
• T15-T19 Consequences of foreign body penetration through natural orifices
• T20-T32 Thermal and chemical burns
• T33-T35 Frostbite
• T36-T50 Poisoning by drugs, medications and biological substances
• T51-T65 Toxic effects of substances, mainly for non-medical purposes
• T66-T78 Other and unspecified effects of external causes
• T79 Some early complications of injury
• T80-T88 Complications of surgical and therapeutic interventions, not elsewhere classified
• T90-T98 Consequences of injuries, poisoning and other effects of external causes

ICD-10 was introduced into healthcare practice throughout the Russian Federation in 1999 by order of the Russian Ministry of Health dated May 27, 1997. No. 170

The release of a new revision (ICD-11) is planned by WHO in 2017-2018.

With changes and additions from WHO.

Processing and translation of changes © mkb-10.com

Consequences of spinal injury ICD 10

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International Statistical Classification of Diseases and Related Health Problems

A complete list of three-digit headings, four-digit subheadings and their contents

Injuries, poisoning and some other consequences of external causes (S00-T98)

This class contains the following blocks:

Consequences of injuries, poisoning and other effects of external causes (T90-T98)

Consequences of injury classified under S00.-

Consequences of injury classified under S01.-

Consequences of injury classified under S02.-

Consequences of injury classified under S04.-

Consequences of injury classified under S05.-

Consequences of injury classified under S06.-

Consequences of injuries classified under S03.-, S07-S08 and S09.0-S09.8

Consequences of injury classified under S09.9

Consequences of injuries classified under S10-S11, S20-S21, S30-S31, T09.0-T09.1

Consequences of injuries classified under S12.-, S22.0-S22.1, S32.0, S32.7 and T08

Consequences of injuries classified in S22.2-S22.9, S32.1-S32.5 and S32.8

Consequences of injuries classified in S14.0-S14.1, S24.0-S24.1, S34.0-S34.1 and T09.3

Consequences of injuries classified in S26-S27

Consequences of injuries classified in S36-S37

Consequences of injuries classified in sections S13.-, S14.2-S14.6, S15-S18, S19.7-S19.8, S23.-, S24.2-S24.6, S25.-, S28.-, S29.0-S29.8, S33.-, S34.2-S34.8, S35.-, S38.-, S39.0-S39.8, T09.2 and T09.4-T09.8

Consequences of injuries classified in S19.9, S29.9 and T09.9

Consequences of injuries classified under S41.-, S51.-, S61.-, and T11.1

Consequences of injuries classified under S42.-, S52.- and T10

Consequences of injuries classified under S62.-

Consequences of injuries classified under S43.-, S53.-, S63.-, and T11.2

Consequences of injuries classified under S44.-, S54.-, S64.-, and T11.3

Consequences of injuries classified under S46.-, S56.-, S66.-, and T11.5

Consequences of injuries classified in S47-S48, S57-S58, S67-S68 and T11.6

Consequences of injuries classified under S40.-, S45.-, S49.7-S49.8, S50.-, S55.-, S59.7-S59.8, S60.-, S65.-, S69.7- S69.8, T11.0, T11.4 and T11.8

Consequences of injuries classified under S49.9, S59.9, S69.9 and T11.9

Consequences of injuries classified under S71.-, S81.-, S91.-, and T13.1

Consequences of injuries classified under S72.-

Consequences of injuries classified under S82.-, S92.- and T12

Consequences of injuries classified under S73.-, S83.-, S93.-, and T13.2

Consequences of injuries classified under S74.-, S84.-, S94.-, and T13.3

Consequences of injuries classified under S76.-, S86.-, S96.-, and T13.5

Consequences of injuries classified in S77-S78, S87-S88, S97-S98, and T13.6

Consequences of injuries classified under S70.-, S75.-, S79.7-S79.8, S80.-, S85.-, S89.7-S89.8, S90.-, S95.-, S99.7- S99.8, T13.0, T13.4 and T13.8

Consequences of injuries classified in S79.9, S89.9, S99.9 and T13.9

Consequences of injuries classified in categories T00-T07

Consequences of injuries classified under T14.-

Consequences of injuries classified under T20.-, T33.0-T33.1, T34.0-T34.1 and T35.2

Consequences of injuries classified under T21.-, T33.2-T33.3, T34.2-T34.3 and T35.3

Consequences of injuries classified in categories T22-T23, T33.4-T33.5, T34.4-T34.5 and T35.4

Consequences of injuries classified in categories T24-T25, T33.6-T33.8, T34.6-T34.8 and T35.5

Consequences of injuries classified in categories T31-T32

Consequences of injuries classified in categories T26-T29, T35.0-T35.1 and T35.6

Consequences of injuries classified under T30.-, T33.9, T34.9 and T35.7

Consequences of poisonings classified in categories T36-T50

Consequences of toxic effects classified in categories T51-T65

Consequences of impacts classified in categories T15-T19

Consequences of impacts classified in categories T66-T78

Consequences of complications classified under T79.-

Consequences of complications classified in categories T80-T88

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ICD code: T91.1

Consequences of a spinal fracture

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Spinal bruise

Spinal contusion is one of the types of spinal cord injury and is classified as a stable injury, accompanied by morphological changes in the spinal cord. The severity of a spinal bruise, its consequences and prognosis directly depend on the mechanism of contusion and the cause of the injury.

Spinal contusion can lead to functional (reversible) or organic (irreversible) damage to the spinal cord - hemorrhages, disorders of the circulation of cerebrospinal fluid, blood circulation, necrotic foci, crush injury, changes in the morphological structure. Possible morphological damage is characterized by preservation of the integrity of the spinal column and spinal cord, but most often it is accompanied by impaired conductivity of the spinal fluid (cerebrospinal fluid). Spinal injuries are considered one of the most complex and dangerous, although they account for no more than 4% of the total number of traumatic injuries to the human body.

According to the International Classification of Diseases (ICD-10), spinal bruise is defined as follows

• S14.0 – contusion and edema of the cervical spinal cord.
• S24.0 – contusion and swelling of the thoracic spinal cord.
• S34.1 – other lumbar spinal cord injury.

Causes of spinal bruise

The etiology of almost all mechanical injuries of the spine is a direct or indirect injury, a blow, which is indicated in the definition of damage - contusio (bruise).

• Causes of spinal bruise:
• A mechanical blow from the outside - a blast wave, a blow from a heavy object.
• A common injury called a “diver’s injury” is a blow when jumping into water with developing damage to the back (flat impact) or cervical spine (impact to the bottom).
• Road traffic accidents.
• Domestic injuries, most often falling from a height.
• Sports injuries (active and contact sports).
• Falling on the back during fainting.
• Compression injury of the spine due to an unsuccessful landing on the feet.
• Violent pressure, a blow to the spine due to rubble.

The etiological causes of spinal contusion are determined by the following damage parameters:

• Strength, intensity of impact.
• Impact speed, the speed of the vehicle involved in the accident.
• The height from which a person falls.
• The height from which an object falls onto the back.
• Age and health status of the injured person.
• The victim's body weight.
• Anatomical features, the presence of chronic deforming diseases of the spine.

From a biomechanical point of view, the most vulnerable areas for injuries and bruises are the upper lumbar and lower thoracic parts of the spine. More than 40% of the total number of spinal cord injuries (SCI) are localized in these areas. The lower cervical area is also often subject to bruises.

Statistically, the causes of spinal bruises look like this:

• More than 60% of all those involved in a car accident receive a spinal bruise of varying severity, 30% of them are diagnosed with a spinal column fracture.
• In 55% of cases, the cervical spine is affected.
• In 15%, the chest area is affected - T-Tx.
• In 15%, the thoracolumbar area is damaged - Tx-L.
• In 15%, the lumbar region is injured.

Symptoms of a spinal bruise

Minor bruises of the spine, unfortunately, are rare; in such cases, only soft tissues are affected and everything is limited to a hematoma; severe contusions are characterized by neurological disorders of varying severity and damage to the spinal cord. Diagnosing bruises of the spinal column is not easy, since the general symptoms are not specific, pain is felt in almost all areas of the spine, and immobility develops. In addition, a sharp disturbance in the excitability of nerve endings, a decrease in all spinal reflexes, characteristic of a concussion - spinal shock overshadows all other clinical manifestations that could specify the diagnosis. The most typical and first symptom of a spinal column injury is a partial or complete rupture of conductivity, accompanied by loss of sensitivity in the areas controlled by the damaged area.

Symptoms of a spinal bruise are varied and depend on the severity of the blow or contusion:

1. Mild spinal contusion is accompanied by symptoms of partial disruption of the conductivity of the spinal cord. Functionally restored within 1-1.5 months.
2. Contusion of moderate severity is characterized by zonal or complete, but not threatening, functional conduction syndrome. The functioning of the spine is restored within 3-4 months, partial residual neurological manifestations in the form of paresis are possible.
3. Severe spinal bruise is characterized by complete damage to conduction, a long recovery period, during which partial neurological disorders of the spinal cord remain and cannot be treated.

Clinical picture of spinal contusion in phases:

• The onset is characterized by symptoms of spinal shock - loss of reflexes, sensitivity, usually below the site of injury, paralysis, difficulty urinating and defecating. Spinal shock often makes diagnosis difficult because the main signs that indicate the severity of the injury appear after the shock has resolved.
• Manifestations of conduction disturbances - partial or complete.
• Changes in movement activity - loss of reflexes (areflexia), paresis (atonic paralysis).
• Gradual loss of sensitivity, spreading down from the site of injury (conductive type).
• Vegetative syndrome – a violation of tissue trophism (dryness, bedsores), a violation of thermoregulation.
• Severe dysfunction of the pelvic organs.
• Complete morphological disturbance of conduction (transverse lesion).

Clinical symptoms of spinal contusion, depending on the area of ​​damage, may be as follows:

• Mild contusion of the spinal column:
  • Sharp pain at the site of injury.
  • Developing swelling, possible hematoma at the site of the bruise.
  • The pain may radiate down the spinal column.
• Bruise combined with injury to the cervical spine:
  • Pain in the bruised area.
  • Impaired respiratory function, shortness of breath, intermittent breathing, possible respiratory arrest.
  • Partial paralysis, paresis, decreased muscle reflexes, tone, sensitivity.
  • Spastic syndrome due to impaired conduction of the spinal cord.
  • Complete paralysis.
• Bruise in the area of ​​the thoracic spinal column:
  • Hypoesthesia, partial loss of sensation in the lower and upper extremities.
  • Complete loss of sensation in the limbs.
  • Ataxia, loss of coordination and control of limb movements.
  • Pain spreading to the heart, left shoulder, arm.
  • Breathing disorders, painful inhalation, exhalation.
• Bruise with injury to the sacrolumbar area:
  • Functional paresis of the legs.
  • Leg paralysis.
  • Loss or reduction of reflexes.
  • Violation of the urination process - incontinence or retention.
  • Impotence in men.

Most often, a mild bruise of the spine is characterized by paresthesia and a feeling of weakness in the limbs, to which the victim does not pay attention. When he seeks medical help, these clinical manifestations have already subsided, however, any contusion requires at least an x-ray examination. It should also be taken into account that a spinal bruise of any severity is always accompanied by structural disorders in the roots, tissue, brain substance, and in the vascular system. Even if the victim does not have signs of spinal shock, all necessary diagnostic measures should be taken to avoid subarachnoid hemorrhages and focal necrosis (myelomalacia). The most dangerous symptom of a spinal bruise is the absence of signs of partial restoration of conductivity and functions during the first two days, which indicates the irreversible nature of the injury and an unfavorable prognosis.

In a clinical sense, spinal bruises vary according to the areas of injury, which are most often localized in the following areas:

Contusion of the lumbar spine

According to statistical data, it occupies more than half of the diagnosed cases and is most often accompanied by paresis of the lower extremities, loss of sensation below the lumbar region and corresponding dysfunction of the urinary system and sphincter.

1. A severe bruise on the L2-L4 line can manifest itself as flaccid paralysis of the extensor muscles in the knee, paresis of the muscles that flex and adduct the hip, and a decrease in the knee reflex.
2. Contusion of the L5-S1 segment is accompanied by partial paresis or complete paralysis of foot movements, paresis of the muscles that control the movement of the knee, hips, atony of the calf muscles - loss of the heel (Achilles) reflex.
3. Contusion at L1-L2 level. In men, it can be diagnosed quite accurately using a superficial cremaster test, as a result of which one can see how the musculus cremaster reflex, the muscle that tightens the testicle, is lost (decreased).
4. Contusion of the lumbar spine, affecting the transverse processes of the vertebrae, is accompanied by complete paralysis of the legs (paraplegia), loss of sensation, atrophy of the muscles of the thighs and buttocks, rectal paralysis, atony or paralysis of the bladder. As a rule, all basic reflexes are lost, but the zones located above the injury site retain normal innervation.

A favorable prognosis for bruises of the lumbar spine is possible if the functions of the pelvic organs and thigh muscles are preserved, flexion movements in the hip joint remain normal, and sensitivity in the feet and ankle joints is preserved. Weakness and minor manifestations of paresis are compensated by therapeutic and rehabilitation measures. You should also pay attention to the fact that contusions of the lumbar region are often accompanied by kidney injuries, which should be excluded or confirmed during diagnosis.

Contusion of the cervical spine

Despite the fact that contusions of the spinal column are usually classified as a stable form of spinal injury, contusions of the cervical spine are most often unstable, since in 90% they are accompanied by displacement of the vertebral body by more than 5-6 millimeters. A bruise in the cervical area, even without signs of a fracture, is characterized as a severe injury and has a high percentage of deaths.

A bruise on the C1-C4 line is most often accompanied by spinal shock and tetraplegia - paralysis of the arms and legs, impaired respiratory function. Often such victims require artificial respiration, ventilation and are almost completely immobilized.

A bruise at the C3-C5 level is characterized by neurological disorders in the form of respiratory distress, when the victim breathes forcefully by contracting the muscles of the chest, neck, and back (auxiliary respiratory muscles).

A severe bruise in the area of ​​the decussatio pyramidum - the transition of the spinal cord into the medulla oblongata - ends in death in 99% due to the cessation of the functions of the respiratory and vascular centers.

A slight contusion of the cervical spine in the decussatio pyramidum area is accompanied by temporary paresis of the arms.

A neck contusion, accompanied by compression of the brain in the area of ​​the foramen occipitale magnum (occipital foramen), is manifested by paresis of the arms and legs, pain in the back of the head, radiating to the shoulder and neck.

A contusion at the C4-C5 level can immobilize the arms and legs, but respiratory functions are preserved.

Contusion of the C5-C6 line is accompanied by a decrease in the radial and biceps reflexes.

Contusion of the C7 vertebra is manifested by weakness of the hands and fingers, and decreased triceps reflex.

Contusion of the C8 vertebra is also characterized by weakness of the wrist, fingers and decreased ankylosing spondylitis (carpal-carpal reflex)

In addition, contusion of the cervical spine is symptomatically manifested by miosis (constriction of the pupils), ptosis (drooping of the upper eyelids), pathological dryness of the face (anhidrosis), and Horner's oculosympathetic syndrome.

Bruise of the thoracic spine

Symptomatically manifested by disorders of the skin sensitivity of the whole body at points called dermatomes: in the area of ​​the eye, ear, supraclavicular, intercostal-brachial, radial, femoral-genital, gastrocnemius and other nerves. Symptoms of thoracic contusion:

• Spinal shock.
• Change in sensitivity according to the conductive type, below the bruise zone.
• Respiratory function may be impaired.
• Contusion of the Th3-Th5 segment is often accompanied by cardialgia.
• Partial paralysis or weakness in the legs.
• Sexual dysfunctions.
• Partial dysfunction of the pelvic organs (defecation, urination).
• Contusion of the vertebrae at the Th9-Th10 level is accompanied by partial paresis of the muscles of the lower zone of the peritoneum, displacement of the navel due to abdominal tension (Beevor's symptom).
• The Rosenbach reflex (lower abdominal reflex) decreases.
• There may be transient pain in the middle back.
• A severe bruise above the Th9 segment is accompanied by complete paralysis of the legs, which is extremely difficult to treat and rehabilitate.

The prognosis is more favorable when the contusion of the thoracic spine is localized in the Th12 segment and below it; in such cases, recovery and restoration of motor activity are possible if there are no fractures.

Contusion of the sacral spine

Almost always combined with injury to the conus medullaris (coccyx). As a rule, after the symptoms of spinal shock, motor activity disorders are not observed, unless there are severe fractures and complete disruption of conduction.

A contusion at the S3-S5 level is accompanied by anesthesia, loss of sensitivity in the perianal, saddle-shaped area; severe contusion may be accompanied by impaired urination and defecation, and temporary erectile dysfunction.

Contusion of the sacral spine at the S2-S4 level is fraught with a decrease in the bulbocavernous and anal reflex.

If the bruise is accompanied by an injury to the bundle of lower roots - the cauda equina, intense pain in the lumbar region, leg paresis, and decreased tendon reflexes are possible.

Contusion of the lumbosacral spine

Most often it is accompanied by flaccid paralysis of certain areas of the lower extremities and conduction-type loss of sensitivity, that is, below the site of injury. Symptoms that may manifest as a contusion of the lumbosacral spine:

• Spinal shock.
• Loss of plantar, cremasteric, and Achilles reflexes.
• Severe contusion is accompanied by decreased knee reflexes.
• All abdominal reflexes are intact.
• Dysfunction of the pelvic organs is possible.
• Contusion of the L4-5-S1-2 segments is manifested by peripheral paralysis (epiconus syndrome), flaccid paralysis of the feet, decreased Achilles reflexes, loss of sensitivity of the muscles of the posterior outer thigh area, impaired urination and defecation.
• Contusion at the S3-5 level is characterized by dysfunction of the pelvic organs with chronic incontinence of feces and urine, loss of sphincter tone with almost complete preservation of leg movements.

Contusions of the lumbosacral area are dangerous due to consequences - chronic atony of the bladder, radicular syndrome, although mild contusions are considered treatable and have a favorable prognosis.

Compression bruise of the spine

Compression bruise of the spine is one of the most common back injuries, which is characterized by compression (flattening) of the vertebral bodies. Compression contusion statistics look like this:

• Compression injury of the cervical spine - 1.5-1.7%.
• Compression contusion of the spine of the upper thoracic zone - 5.6-5.8%.
• Compression of the mid-thoracic area of ​​the spine – 61.8-62% (level IV-VII).
• Compression contusion of the lower thoracic region – 21%.
• Compression of the lumbar zone – 9.4-9.5%.

The cause of compression bruises is intense axial load, jumping from great heights and unsuccessful landing on the feet, and less often, a fall from a height.

A bruise accompanied by compression of the spinal cord is associated with constant irritation of the corpus vertebrae (vertebral body) by bone fragments and internal hematomas resulting from injury.

The first clinical signs of spinal cord compression are aching back pain, and less commonly, radicular syndrome. These symptoms may appear several weeks or months after the injury (jump, fall), when the compression process has already entered the acute stage. Most often, a compression bruise is diagnosed in the thoracic region and is manifested by muscle weakness, a gradual decrease in the sensitivity of the hands, changes in the functions of the pelvic organs (frequent urination, urinary retention, defecation disorders), and sexual dysfunction. Clinical signs of compression bruises progress quickly, therefore, when the first signs appear and there is a history of bruises, you should immediately contact a traumatologist or vertebrologist.

Severe spinal bruise

A severe contusion of the spine in clinical practice is much more common than a concussion of the spinal cord with a mild contusion, since a severe contusion, as a rule, is a consequence of a subluxation or fracture of a vertebra (or vertebrae). Such contusions are diagnosed as irreversible, since they lead to organic, structural damage to the substance of the spinal cord, to hemorrhage and the formation of necrotic foci. A severe contusion of the spine always manifests itself as a pronounced spinal shock in the clinical sense and often leads to the following complications:

• Thromboembolism at the site of injury or in other areas.
• Ascending edema of the Myelencephalon - the medulla oblongata with a contusion of the cervical spine.
• Thrombosis - vein thrombosis.
• Traumatic bronchopneumonia.
• Infections, sepsis of the urinary tract.
• Joint contractures.
• Decubitus - bedsores.

A severe contusion of the spine can have a very unfavorable prognosis if the outer shell of the spinal root is completely destroyed, if functions and reflexes are not restored, at least partially, within two days after the injury.

Treatment of spinal bruise

Therapeutic measures and treatment of spinal contusion directly depend on timely consultation with a doctor and comprehensive diagnosis, which includes X-ray examinations (CT, MRI), myelography and other methods. In any case, even with an unclear diagnosis, victims of spinal contusion are treated as patients potentially having a serious spinal injury.

The main methods of treating spinal contusion include first aid, careful transportation, long-term complex therapy and rehabilitation measures. If the bruise is diagnosed as mild and after a day the patient’s functions and reflexes are restored, treatment at home is possible with strict bed rest, immobilization of the affected area, massage, and thermal treatment procedures. In more serious situations, hospitalization is necessary, where both conservative and surgical treatment is possible. Severe bruises, accompanied by life-threatening symptoms, require intensive therapeutic actions - restoration of blood pressure, breathing, and heart function.

In the hospital, closed reduction of the resulting deformities is used, traction and immobilization with the help of corsets and collars are possible. The surgical method of neutralizing spinal deformities helps eliminate compression injury and restores blood circulation to the injured area. Reconstructive surgery is also indicated in cases where conservative treatment for a long period does not produce results. It should be noted that treatment of spinal contusion currently involves the use of new, modern techniques, when traumatologists try not to resort to surgical intervention and use effective hardware techniques.

First aid for spinal bruises

The first action that must be applied to the victim is to ensure complete immobilization. If a person is lying down, under no circumstances should he be moved or lifted, as this may worsen damage to the spinal cord (compression). The victim is carefully turned onto his stomach and carefully moved face down onto a stretcher. If it is possible to transport on a hard surface, a shield, then the patient can be placed on his back.

First aid for a bruise of the spine in the cervical region consists of immobilizing the collar area with special splints or dense fabric (without squeezing). In addition, you can apply cold to the site of the injury, and if respiratory functions are impaired, provide assistance in the form of artificial respiration. Other independent actions are unacceptable, since spinal injuries, even bruises, require the actions of specialists. The most important thing in case of a spinal bruise is to deliver the victim to a medical facility as quickly as possible, where all necessary measures adequate to the injury will be taken.

What to do if you have a spinal bruise?

The first steps are to try to ensure complete immobilization of the victim and apply a cold compress to the injury area to relieve swelling and spread of the hematoma. Next, the question of what to do in case of a spinal bruise will be answered by a traumatologist, surgeon or the doctor who will see the patient in a medical institution. As a rule, the algorithm of actions of doctors is as follows:

• Transporting the victim to the hospital.
• Urgent diagnostic measures, assessment of the patient's condition.
• Symptomatic therapy, possibly intensive therapy.
• If the condition is assessed as stable, nothing is required other than immobilization of the injured area, symptomatic therapy and observation.
• If the condition is unstable, reduction and subsequent immobilization or stabilizing surgery is necessary.

What to do if you have a spinal bruise if the injury occurred at home and there is no one nearby to provide first aid? It is necessary to urgently call emergency medical assistance, and try not to move until it arrives. Even if the bruise is assessed by the victim as mild, it is necessary to undergo an X-ray examination, exclude possible complications and receive professional recommendations on restoring the functions of the spinal column.

How to prevent spinal bruises?

Prevention of spinal contusion is mainly preventive measures against recurrence of injury and possible complications. Unfortunately, it is not possible to prevent spinal bruises, since etiologically they are caused 70% by household and emergency factors, 20% by sports, and only a small percentage is due to negligence or accidental situations. Prevention of spinal contusion is a reasonable load on the spinal column, training the muscular corset, normalizing body weight, maximum caution on the road and compliance with safety rules at home, treatment of spinal diseases - osteochondrosis, osteoporosis and others. It should be remembered that the spine bears a heavy load throughout our lives and makes it possible not only to move, but also to feel like a full-fledged person. If you take care of your foundation, and it is no coincidence that the spine is called Columna vertebralis - a load-bearing pillar, then it will never lead and will serve for a long time.

Recovery time for spinal bruises

The recovery time and prognosis for bruises depend on the severity of the concussion, the characteristics of the human body, the presence of concomitant diseases, the area of ​​injury and other factors. A spinal bruise, the recovery period of which is difficult to predict, is a form of spinal injury, and in any case is accompanied by a disruption of the cerebrospinal fluid and subarachnoid hemorrhage. The recovery period is associated with the period of reduction of swelling and the ability to regenerate damaged nerve endings and restore soft tissue trophism. Moderate bruises take a long time to heal and the rehabilitation period can take at least a year, although movement is partially restored 2 months after the start of treatment. Severe bruises tend to retain partial symptoms throughout life, since damage to the sheath of nerve endings cannot be restored, and some spinal functions are often lost. It should be noted that a bruise cannot be considered a minor injury, since it is often accompanied by fractures and subluxations, which is statistically predicted as 40-50% of the disability of a particular group. In this sense, a spinal bruise is no less serious an injury than a brain injury, and the recovery period is similar to the rehabilitation period for brain injuries. The main condition for a possible speedy recovery can be considered timely, competent assistance and the desire of the victim himself to follow all medical recommendations, including long-term rehabilitation courses.

Medical Expert Editor

Portnov Alexey Alexandrovich

Education: Kyiv National Medical University named after. A.A. Bogomolets, specialty - “General Medicine”

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Spinal cord injury and its consequences

RCHR (Republican Center for Health Development of the Ministry of Health of the Republic of Kazakhstan)

Version: Clinical protocols of the Ministry of Health of the Republic of Kazakhstan

general information

Short description

Expert Commission on Health Development of the Ministry of Health of the Republic of Kazakhstan

S12.0 – Fracture of the first cervical vertebra.

S12.1 – Fracture of the second cervical vertebra

S12.2 – Fracture of other specified cervical vertebrae

S12.7 – Multiple fractures of the cervical vertebrae

S13.0 – Traumatic rupture of the intervertebral disc at the level of the neck

S13.1 – Dislocation of the cervical vertebra

S14.0 – Contusion and edema of the cervical spinal cord

S22.0 – Fracture of the thoracic vertebra

S22.1 – Multiple fractures of the thoracic spine

S23.0 – Traumatic rupture of the intervertebral disc in the thoracic region

S23.1 – Dislocation of the thoracic vertebra

S24.0 – Contusion and swelling of the thoracic spinal cord

S24.1 – Other and unspecified thoracic spinal cord injuries

S32.0 – Fracture of the lumbar vertebra

S33.0 – Traumatic rupture of the intervertebral disc in the lumbosacral region

S 33.1 – Dislocation of the lumbar vertebra

T91.1 – Consequences of a spinal fracture (spinal instability, pain, etc.)

T91.3 – Consequences of spinal cord injury (spastic and pain syndrome, etc.)

HIV – human immunodeficiency virus

Gastrointestinal tract - gastrointestinal tract

KMA – potassium magnesium aspartate

CT – computed tomography

Exercise therapy – therapeutic physical culture

MRI – magnetic resonance imaging

BCC – volume of circulating blood

FFP – fresh frozen plasma

ESR – erythrocyte sedimentation rate

UHF – ultra-high frequency therapy

Ultrasound – ultrasound examination

PSCI – spinal cord injury

Users of the protocol: neurosurgeons, neurologists.

Classification

1. Upper cervical injury (C0-C2):

Fractures of the condyloid processes.

Traumatic atlantoaxial instability.

2. Cervical injury (subaxial) at the C3-T1 level.

3. Chest injury at the Th1-Th10 level.

4. Thoracolumbar injury at the level of Th11-L2.

5. Lumbar injury at L2-5 level.

6. Damage to the sacral spine.

7. Multiple spinal injuries

8. Multi-level spinal injuries

1. With partial violation

Anterior column syndrome

Posterior column syndrome

2. In complete violation

1. Group A, complete: There is no motor or sensory function in the sacral segments S4-S5.

2. Group B, incomplete: Sensitivity is preserved, but motor function is absent in segments below the neurological level, including S4-S5.

3. Group C, incomplete: Motor function below the neurological level is preserved, but more than half of the key muscles below the neurological level have strength less than 3 points.

4. Group D, incomplete: Motor function below the neurological level is preserved, and at least half of the key muscles below the neurological level have a strength of 3 points or more.

5. Group E, normal: motor and sensory functions are normal.

1. Spinal or uncomplicated spinal injury.

2. Spinal cord injury.

3. Spinal cord injury.

1. Spinal cord concussion.

2. Contusion of the spinal cord and/or roots.

3. Compression of the spinal cord and/or roots.

4. Partial interruption of the spinal cord.

5. Complete anatomical break of the spinal cord and/or roots.

1. Contusion of the soft tissues of the spine.

2. Partial or complete rupture of the capsular-ligamentous apparatus of the spinal motion segment.

3. Self-reduced vertebral dislocation.

4. Intervertebral disc rupture.

5. Dislocations of the vertebrae.

6. Fractures and dislocations of the vertebrae.

7. Vertebral fractures.

1. Isolated PSMT

2. Combined SCI

3. Combined PSMT

1. Acute period (first 3 days)

2. Early period (from 3 days to 3-4 weeks)

3. Intermediate period (from 1 to 3 months)

4. Late period (more than 3 months)

1. Compression (type A1-3)

2. Distraction (type B1-3)

3. Rotary (type C1-3)

Diagnostics

II. METHODS, APPROACHES AND PROCEDURES FOR DIAGNOSIS AND TREATMENT

1. X-ray of the spine in 2 projections (direct and lateral)

2. CT scan of the spine

3. Complete blood count (6 parameters), red blood cells, hemoglobin, leukocytes with leukocyte formula, hematocrit, platelets, ESR, coagulability

4. Biochemical blood test (determination of residual nitrogen, urea, total protein, bilirubin, calcium, potassium, sodium, glucose, AlT, AST)

5. Blood test for HIV.

6. Blood for hepatitis B, C

7. General urine test

11. Consultation with a therapist

12. Consultation with a surgeon, traumatologist.

13. X-ray of the chest organs.

14. Ultrasound of the abdominal organs

1. Consultation with specialists on indications

2. MRI of the spine.

Complaints of pain in the area of ​​spinal injury, motor and sensory disorders (segmental and/or conduction), dysfunction of the pelvic organs, depending on the degree of damage to the spinal cord and its structures.

Anamnesis: the mechanism of injury, time, symptoms that arose immediately at the time of injury, subsequent measures (first aid, transportation, treatment and its effectiveness at previous stages, dynamics of symptoms) are clarified.

Presence of local pain syndrome; changes in the axis of the spine, in some cases kyphotic deformation in the area of ​​damage; antalgic reflex muscle contraction; swelling, bruising, there may be abrasions and soft tissue wounds; restriction or impossibility of movements in the spine. Neurological disorders - impaired sensitivity, motor function, dysfunction of the pelvic organs below the level of damage.

There are no significant deviations in clinical and biochemical tests in the absence of concomitant pathology. Perhaps a decrease in red blood counts due to hemorrhage in the area of ​​spinal injury.

Spondylograms, CT scans, and MRI scans reveal varying degrees of damage to the spine and spinal cord structures.

Spondylograms are performed in two standard projections (frontal and lateral). If an injury to the upper cervical spine is suspected, an additional x-ray is taken through the open mouth.

CT and MRI are performed in three standard projections: sagittal, frontal and axial + CT with 3D reconstruction.

According to indications, densitometry of the cancellous bones of the skeleton is performed to diagnose a pathological fracture against the background of osteoporosis.

If the functions of vital organs are impaired, consult a resuscitator;

If traumatic injury to internal organs is suspected, consult a surgeon;

In the presence of concomitant pathology, consultation with relevant specialists: in case of changes in the ECG - consultation with a cardiologist, therapist, in case of endocrine pathology - with an endocrinologist and others.

Compression fracture of the spine, ICD code 10

Chest injury with spinal fracture

Patients often go to the hospital complaining of severe pain in the spine. After examination and diagnostic results, the doctor makes a disappointing diagnosis - a fracture. Among all types of chest trauma, a compression fracture of the thoracic spine is very rare. Treatment of a fracture is conservative; rehabilitation is considered an important step on the path to full recovery.

Classification according to ICD – 10

A feature of a compression fracture is the compression of the vertebrae, they become smaller, as if they sag when injured, and the height of the spinal column changes. Relatively harmless consequences are caused by a fracture of the 12th vertebra and injury to the 1st and 2nd lumbar vertebrae.

When the spine is fractured in the chest area, the 6th, 11th, and 12th vertebrae are most often affected, although injuries to other vertebrae also occur. Thoracic spinal injuries have specific codes in the International Classification of Diseases:

• ICD - 10 codes S20 - S29 are chest injuries.
• ICD - 10 under code S00 - T98 - various injuries, poisoning, as well as other consequences.
• ICD - 10 code S22.1 - multiple injuries of the thoracic spine.
• ICD-10 code S22 registered fractures of the ribs, sternum, and thoracic vertebral region.
• ICD - 10 code S22.0 - injury to the thoracic vertebra.

Fractures or injuries of the spine are assigned an individual code in the ICD-10 registry. Thus, it is much easier to systematize knowledge and data about various diseases, mortality, as well as how to store, analyze, study and compare the information received.

Features of the fracture

Elderly people suffering from osteoporosis come to the clinic with similar injuries. Patients at risk are those suffering from:

• vertebral tumors;
• endocrine and chronic somatic diseases;
• anorexia;
• cachexia;
• hormonal disorders;
• rickets;
• anemia.

Women during postmenopausal and menopausal periods should be careful.

What are the risks of injury?

In ICD-10, where spinal injuries are classified under a certain code, not only treatment is described, but also the consequences of the injury. Unlike fractures of the lumbar and thoracic vertebrae, injuries to the cervical vertebrae, especially the fifth, are considered the most complex and life-threatening.

Compression fractures of the spine in the chest area occur infrequently, and then only in the event of a strong blow. But even so, a person, feeling severe pain, does not dare to see a doctor, believing that everything will go away on its own. The consequences of such patience can lead to major health problems in the future.

The consequences of spinal damage due to osteoporosis are especially unpleasant. In this case, spinal injury can occur even when sneezing or coughing. Osteoporosis is a pathology as a result of which the spine begins to change, the strength of its vertebrae decreases due to a lack of calcium and bone loss. People suffering from osteoporosis may not even be aware of the injury and may walk with it for a long time. When you consult a doctor after diagnosis, the results will be disappointing - an old spinal fracture. Surgical treatment will be required.

The consequences of a compression fracture of the lumbar vertebrae are not very pleasant, since they are responsible for withstanding maximum loads. In any case, if you experience a spinal injury and the first signs of pain, you should consult a doctor.

Signs of serious injury

A fracture of the 6th, 11th, 12th vertebrae is indicated by pain in the back; it intensifies when the patient takes a breath or any other movement, for example, changes body position. In addition to pain, other primary symptoms are noted:

• aching back pain;
• hematoma formation;
• swelling at the fracture site;
• bruises and bruises on the back;
• tingling, numbness of the lower extremities.

If the fracture is not detected immediately, but after some time, a hump may form in the chest area. Loss of sensitivity, cuts, paralysis are symptoms indicating that the spinal cord has been damaged due to a spinal injury. Violation of the functions of internal organs is often observed. A fracture resulting from a road accident can lead to pneumothorax, lung rupture, and heart injury. Symptoms of injury manifest themselves in the form of impaired functionality of the muscular frame of the back, and the patient’s breathing is also difficult.

When examining a patient, it is very important to find out whether he suffers from neurological disorders. Painful symptoms with compression fractures are very pronounced if the injury occurred as a result of the formation of malignant tumors and metastases.

X-rays, computed tomography, and other diagnostic methods will help detect the degree of damage to the 6th, 11th, 12th and other vertebrae. Additionally, the doctor recommends an examination of the lumbar vertebrae, after which the correct treatment, therapeutic exercises, and massage are prescribed.

Children suffering from a spinal fracture

A spinal fracture in children according to ICD-10 is a complex injury that can lead to dangerous consequences. Trauma can be difficult to detect at a young age. In children, injury can occur simply due to negligence, for example, while diving or jumping on the buttocks. Sometimes parents ignore their children’s complaints, believing that these are ordinary whims and the pain will soon go away on its own. Seeing a doctor is the best decision for parents, because it is the primary pain symptoms in the chest that indicate a vertebral injury in children.

When falling or jumping, vertebrae 6, 11, 12, and others are compressed, the anterior part of the spine suffers from strong pressure, but the thoracic part in the middle part is most injured from the load. In children, when a vertebra is fractured, its integrity is compromised; vertebral deformity and severe pain are noted at the site of injury.

As a treatment, children are prescribed drug therapy and a corset. After complex treatment, rehabilitation is required, special exercises are prescribed to restore the functions of the spine.

Treatment methods

Treatment of fractures of the 6th, 11th, 12th and other vertebrae is conservative. The patient is prescribed bed rest; a special corset will ensure a stable position of the spinal column. Taking analgesics will relieve pain, but will not cure the injury. Surgical treatment is used only in extreme cases. It takes about three months for the fracture to heal, followed by long-term rehabilitation, which includes physical exercise.

Fixing bandage

Treatment of a compression fracture of the thoracic spine according to ICD-10, in order to ensure a stable position of the damaged vertebra, involves wearing a special bandage, in other words, the patient needs to wear a corset. In this way, it is possible to reduce the load on the vertebrae and provide them with minimal mobility. The corset will need to be worn for about 4 months. It is necessary for fractures of the cervical vertebrae.

A corset applied for a fracture can be:

Also, the corset can be solid or with fasteners, even warming. It is chosen depending on the severity of the fracture and the patient’s well-being. It is best to choose a corset that has several degrees of fixation that you can independently adjust. The corset will help damaged vertebrae heal faster and correctly. The patient should wear the orthopedic corset regularly until the doctor allows it to be removed and prescribes therapeutic exercises.

Gymnastics

Not only does the corset help to strengthen the 12, 11, 6 and other vertebrae in case of a compression fracture, the rehabilitation period includes regular exercise therapy. Exercises are necessary in order to develop the back muscles after wearing a corset for a long time.

It is necessary to select exercises taking into account the patient’s well-being and the complexity of the injury. It is important to follow the sequence of physical activity that the exercises will consist of.

The exercises may feel painful while performing them, so it is best to perform them under the supervision of a specialist. When the patient has mastered all the exercise therapy exercises and can do them without outside help, he can continue the exercises at home.

Treatment of the spine with exercise therapy will allow you to:

• strengthen your back muscles;
• support the spinal column;
• improve spinal mobility;
• straighten your posture;
• improve coordination of movements.

You need to do the exercises slowly, paying attention to the pain symptoms that arise with any movement, and strictly following all the instructions and recommendations of the doctor. If the pain is severe, it is better to pause and stop exercising for a while until the discomfort goes away completely. Loads should be gradual.

Rehabilitation is an important stage on the path to full recovery, restoration of spinal function, and return to your previous lifestyle.

Symptoms, first aid, transportation and treatment of vertebral compression fracture

A compression fracture of the spine is one of the types of injuries accompanied by compression of the bodies of the segments and nerve endings. This develops as a result of strong impact, resulting in compression of the vertebrae with a change in their height and anatomical integrity. First aid for a spinal fracture should be provided immediately. Otherwise, there remains a high risk of complications.

Types of compression fracture

Any damage to the vertebrae causes serious harm to the human body. This condition requires immediate decision-making and first aid. Fractures are characterized by the severity of the damage and the duration of the recovery process. This is reflected by the ICD 10 code after the diagnosis. Main types of fractures:

1. Non-penetrating damage. Occurs in 38% of all cases. Develops with compression occurring without the caudal and cranial endplate. This condition is characterized by damage to adjacent discs. Regeneration is progressing well.
2. Penetrating damage. This form of spinal fracture is one of the most severe. The damage involves the cranial endplate and disc. Reparation is characterized by an unfavorable course.
3. Splinter damage. As a result of this process, the formation of a false joint cannot be ruled out. If the fracture is old, conservative treatment does not have the desired effect. Surgical intervention is characterized by a certain complexity.

In addition to the classification described above, fractures are divided into the following:

A consolidated fracture is not diagnosed so often. The cervical spine is affected in rare cases. Depending on the complexity of the damage, the following types of fractures are distinguished:

1. First degree. This type is characterized by a decrease in the height of the vertebrae. Grade 1 fractures are not severe. They proceed much easier than others, the recovery period is not long;
2. Second degree. Damage of this type is more common. They are characterized by a reduction in the height of the vertebrae by half;
3. Third degree. The fracture is serious. The height of the vertebrae is reduced by more than half.

A high-quality diagnosis will help you recognize what type of fracture it is and what measures to take.

Risk factors and clinical picture

The impact of an impressive force on the spine leads to the development of a compression fracture. Excessive axial loads can affect this process. In particular, hitting the ground due to a fall from a height. In addition, other causes of fractures are recorded. Damage may occur due to subsidence of the cartilage located between the vertebrae. This develops as a result of diseases of the musculoskeletal system. This can lead to loss of shock-absorbing properties of the intervertebral disc. Because of this, bone structures become vulnerable. The likelihood of damage is high.

A fracture can develop against the background of osteoporosis. This disease is characterized by changes in the structure of bone tissue. The vertebrae become fragile due to weakening. This significantly increases the risk of developing a fracture. This condition is more often recorded in older people. Osteoporosis causes a person to decrease in height and develop a hump. In extremely rare cases, a fracture develops due to metastasis.

The manifestation of symptoms in case of damage depends entirely on its location and severity. The reason that resulted in the fracture may also affect this process. In this regard, there are several main types of damage that have their own symptoms.

A compression fracture is characterized by acute and sharp pain. It is localized in the lumbar region, with subsequent spread to the limbs. If the nerve endings are damaged, sensitivity is significantly reduced, the body may become numb, and severe weakness appears. Other neurological symptoms cannot be excluded.

If there is a gradual destruction of the vertebrae, the victim experiences moderate pain. Over time, it can intensify. This condition occurs against the background of progression of osteoporosis. Often, spinal fractures can lead to serious consequences, such as damage to the spinal cord. This leads to the development of additional symptoms. Severe pain syndrome is complemented by damage to internal organs, in particular the pelvis. If a decompression fracture is noted, the clinical picture is diluted by acute pain during breathing.

First aid

First aid must be provided according to the rules. Ignorance of them can lead to a worsening of the victim’s condition. Particular importance is given to the position of a person during transportation. Compliance with the rules of first aid increases a person’s chance of a normal existence. Thus, the victim must be transported on a hard surface.

If possible, the person should be given analgesics to reduce pain. The damaged area must be well fixed. Without special tools at hand, this is difficult to do. In this case, it is recommended to immobilize the entire spine. Any hard surface is perfect for this action. This can be a wide board or tabletop. The victim must be tied to the surface to avoid falling.

The cervical region requires fixation, head movements must be limited. This will prevent further damage. It is possible to shift the patient, but with the help of three people. The action must be performed synchronously. Under no circumstances should you sit the victim down or try to get him to his feet. You should not pull his limbs, try to straighten his vertebrae, or give medicine if he is unconscious.

Knowing the basic rules of first aid can be useful to everyone. Proper implementation will increase the victim’s chance of a normal existence.

Diagnostic measures

The first step is a visual inspection and palpation of the spine. The main signs of a fracture are visible to the naked eye. The affected area is characterized by acute pain. If the fracture is accompanied by splinters and fragments, they can be easily felt during palpation. Based on these data, a preliminary diagnosis can be made. But without additional diagnostic methods it is impossible to prescribe the correct treatment.

The visual examination is usually followed by an x-ray. It allows you to identify pathologies in the spine that could result in a fracture. X-rays are performed in direct, lateral and oblique projections. Consultation with a neurologist is mandatory. This will test the functional abilities of the spinal cord. This technique is also aimed at monitoring the performance of nerve endings.

A functional radiograph is particularly informative. During this procedure, the vertebrae should be extended as much as possible. Based on the data received, the orthopedist assesses the condition of the spine. To make a correct diagnosis, additional diagnostic methods are used. Thanks to them, you can notice any deviations in the spine. X-rays are performed not only to make a diagnosis, but also to monitor the process of bone fusion.

Another type of study is myelography. Its main purpose is to determine the general condition of the spinal cord. Computed tomography and magnetic resonance imaging can be used as additional diagnostic procedures. A general blood test is often performed. This will allow us to identify the main amount of all substances contained in its composition.

After carrying out diagnostic measures, the doctor can determine the type of pathology. There are three main types: flexion, axial or rotational damage. Classification of the fracture helps in creating a treatment plan for the patient.

Patient management tactics

Elimination of spinal injuries can be carried out in several stages. It all depends on the complexity of the situation and the condition of the victim himself.

Conservative treatment. A compression fracture first requires eliminating pain and limiting activity. In addition, the position of the victim must be recorded. Modern treatment is based on the use of vertebroplasty and kyphoplasty. These methods are considered minimally invasive; due to certain features, they give good results in the fight against fractures. Complete fusion of the bones will take at least 3 months. During this period you will have to follow some rules.

Treatment of pain syndrome. Analgesics will help relieve severe pain. They are taken orally or by intramuscular injection. More often they resort to the help of analgin, ibuprofen and diclofenac. In severe cases, ketanov and novocaine are used.

Limiting activity. A person needs to sit and stand less, the optimal position is lying down. Under no circumstances should you lift heavy objects or perform activities that could increase the load on the spine. It is best to treat a compression fracture with bed rest. Especially if the victim’s age exceeds 50 years.

Fixation. Certain types of lesions require the use of special fixation braces. This will stabilize the spine and limit its movement. Thus, the torso is always in the correct position. This improves the process of vertebral fusion.

Invasive methods. To eliminate fractures, some doctors use modern methods. This could be vertebroplasty, which involves injecting special “cement” into the broken vertebrae.

This method will reduce pain and increase the strength of the spine. The second treatment method is kyphoplasty. Thanks to it, complete restoration of the height of the spine is achieved. The method involves inserting a balloon into the vertebral body. This will restore altitude. The ball itself is filled with bone cement, thereby holding the spine in the correct position. These methods are more often used in adults; they are not practiced in children.

Surgical intervention. If a compression fracture is characterized by instability and is accompanied by neurological complications, surgical methods are resorted to.

Surgical intervention is based on the removal of damaged fragments that have a pronounced effect on the nerve endings.

Instead, special metal clamps are installed.

How to treat a compression fracture is decided by the attending physician. Much depends on the complexity of the injury and the condition of the patient.

Compression fracture of the spine

The increase in the number of children's playgrounds and various inflatable attractions has radically changed the nature of injuries received. Previously, doctors had to treat patients with fractures of legs, arms, and depression of the skull, but today compression fractures of the spine are in the lead.

Injuries received on the playground are a separate line, followed by all the others - from accidents, falls from heights, landings on the “butt”, lifting heavy objects.

The mechanism of fractures itself has changed. Until recently, it was believed that after a direct blow, the vertebrae were compressed. As a result of deformation, they take the shape of a wedge. The elements of the lumbar and thoracic spine are most often affected. And now you can get injured simply by falling unsuccessfully on your back or flat on your face.

Perhaps the reason lies in the peculiarities of modern nutrition and the lack of nutrients.

Sometimes a fracture makes itself known after some time. After a fall, a person gets up and goes home. But then the pain returns, accompanied by limited movement and other symptoms.

Compression fracture, what is it? This name is given to damage to the vertebrae as a result of strong compression when their height decreases. They are literally flattened, their body cracks. This occurs when the spine bends and contracts at the same time.

In medicine, a disease has its own alphanumeric designation - ICD 10 code. This is done specifically to make working with documents easier. The code has several variants, depending on the damage to individual vertebrae or components.

The main causes of such fractures are:

• traffic accidents, accidents;
• diving into a shallow body of water and hitting your head on its bottom;
• landing while jumping on straight legs;
• falling on your back with a heavy object.

Trauma is associated with the risk of debris damaging the spinal cord vertebrae, which is known to lead to paralysis.

Compression fracture of the lumbar spine

The 11th and 12th vertebrae are the most commonly affected by fractures because they are under a lot of pressure.

Based on the strength of deformation, compression fractures are divided into three types:

1. Fractures of the 1st degree are characterized by a change in the height of the vertebrae by less than half.
2. With a grade 2 fracture, the vertebral body is flattened twice.
3. A grade 3 fracture means a decrease in height by more than 50%.

Self-medication or complete inaction can cause unpleasant consequences in the form of deformation of the spinal column and injury to nerve endings. When a damaged vertebra puts pressure on the nerve roots and destroys the soft cartilage tissue of the disc, radiculitis or osteochondrosis may develop.

Symptoms of a fracture in the lumbosacral region (injury group code S32):

• a sign of a compression fracture is pain in the back and limbs, which gradually intensifies;
• the head begins to feel dizzy, the person quickly gets tired and becomes weakened;
• increased compression of the spinal cord occurs.

Treatment should begin immediately after the first signs of the disease appear. Contact your doctor who will prescribe a course of treatment procedures.

Most often, a positive effect is achieved through the use of conservative methods: the use of an orthopedic corset to fix the spine, new methods of increasing the vertebral body - kyphoplasty, vertebroplasty.

Rehabilitation is considered an important stage of recovery after treatment. The entire outcome of the treatment depends on its successful completion.

The main treatment method for compression of the vertebrae is a complex of exercise therapy, which strengthens the muscles, preparing them for active movement. Correct formation of the muscle corset is the key to successful restoration of the vertebrae.

Gymnastics is necessarily included in any rehabilitation program.

The doctor selects exercises based on the patient’s condition and the complexity of the fracture. Basically, the exercises are performed while lying on your back. Turn on your stomach and practice proper breathing. Initially, it is forbidden to raise your legs with your heels off the bed. Then the movements gradually become more complicated, their number and intensity increase.

Compression fracture of the thoracic spine

This type of fracture takes second place after lumbar fractures. The first vertebra is damaged the most, followed by the rest. The cause is a variety of injuries - domestic, industrial, road accidents, sports, osteoporosis.

Symptoms of thoracic vertebral fractures (group code S22):

• Spinal deformity is visually determined;
• The muscular frame is tense;
• The person experiences pain, shortness of breath, weakness, numbness of the hands;
• Difficulty moving the spine.

Based on the severity of damage, fractures of the thoracic vertebrae are also divided into three degrees of deformation. The easiest treatment is for grade 1 fractures. They are difficult to notice, but they can have serious consequences in the form of radiculitis or osteochondrosis.

The danger is posed by vertebral fragments, which easily affect nearby tissues and the spinal cord, which leads to numbness of the limbs and decreased sensitivity. Curvature of the chest may also occur, causing a hump to form on the back.

If the thoracic vertebrae are destroyed, the person must be immediately immobilized so that the bone fragments do not have time to move. The patient should be placed on the stretcher slowly, as carefully as possible. The surface should be hard, a cushion should be placed under the lower back. After this, you can give the person a pain reliever.

The course of treatment is chosen after a thorough diagnosis of the patient’s condition. The procedures are carried out in the clinic under the supervision of an instructor.

Rehabilitation is carried out using special equipment. It is designed to eliminate spinal deformity, ensure blood flow to diseased tissues, and restore flexibility and mobility to the back.

Exercise therapy is mandatory. Rehabilitation exercises can be done at home, but when a specialist is nearby, they will be more effective. The gymnastic complex is aimed at normalizing breathing, improving the functioning of the muscular corset, and preparing for stress in a vertical position.

Compression fracture of the spine in children

The main cause of injury to children is oversight on the part of parents, their inattention to their own children - where they go, what they do.

Physiotherapeutic procedures, massage, physical therapy, and swimming help treat and recover from vertebral injuries.

How to determine if a child has a compression fracture? If your baby falls and complains of severe pain, there is no need to panic right away. Place your child on his back and ask him to inhale through his nose and exhale through his mouth several times. This is necessary to normalize breathing. If you notice a spasm of the respiratory organs, this will be the first sign of a vertebral fracture.

If the child can move his legs, arms, hears you, reacts to your words, then everything is fine. Pick him up carefully and take him home. When children cannot get up, do not force them, but immediately call an ambulance.

Tell them that the child was injured while walking outside. For doctors, this will be a signal that they need to come promptly. If, after undergoing a tomography, abnormalities are detected, the fracture will be treated immediately.

And in general, it will never be superfluous to show a child after an unsuccessful fall to a traumatologist. You never know... delaying treatment will result in long-term treatment and subsequent rehabilitation.

If the damage is small, the symptoms may be hidden. The presence of a compression fracture can be determined through careful diagnosis. With palpation, you can feel the sore spot. After pressing on the head or forearms, the child will experience pain due to the damaged vertebra.

More complex injuries to the thoracic region limit movement, make breathing difficult, and are accompanied by girdling abdominal pain. If several vertebrae are damaged, then wearing a corset is prescribed. During treatment, children are prescribed bed rest to relieve the spine as much as possible.

A growing body quickly returns to normal after a fracture, tissues grow quickly, and rehabilitation is successful. Complicated cases are treated with minimally invasive surgical methods. Injuries in children can have their consequences - the development of scoliosis or kyphosis, osteochondrosis. Therefore, doctors monitor the condition of an injured child for two years.

In older people

With age, in the absence of optimal physical activity, the process of demineralization of bone tissue begins. Due to a deficiency of magnesium, calcium and other elements, bones in older people become fragile and brittle. This condition inevitably increases the likelihood of spinal compression.

Sometimes a person manages to get 5-6 compression fractures of the spine at the same time. His spinal column folds like a deck of cards. In this case, axial loads should be avoided.

After 70, osteoporosis contributes to the destruction of the vertebrae, and a hump begins to form as a result of kyphotic curvature. Tumors, coupled with metastases, put pressure on the spine, which becomes damaged over time. Treatment should be started promptly to avoid complications associated with spinal cord injury.

In older people, pain does not appear immediately, but increases over time, gradually. A person does not immediately realize that he has compression. He continues to live, actively move, as if nothing had happened, and this leads to damage to blood vessels and nerve fibers. At a later stage, your health begins to deteriorate, your ability to work decreases, and weakness appears - these are symptoms of a compression fracture.

The doctor prescribes treatment after examining the symptoms of the disease. X-rays in different projections help to create a general picture of the damage. A more accurate diagnosis can be made using computed tomography.

How to treat a fracture

For such diseases, medicine provides a whole range of procedures. Not only the cause of the disease itself is treated, but also the pathologies that accompany it. It is usually recommended to take painkillers, anti-inflammatory drugs, chondroprotectors and conservative physiotherapy. The vertebrae are fixed in the correct position using corsets. At the same time, osteoporosis is treated.

Upon completion of the main course, you will have to take a vitamin complex for a long time to replenish the bones with useful substances. Daily gymnastics helps to return to the usual rhythm of life.

If conservative methods do not help, there is a threat to the patient’s health, surgical intervention is performed to fix the vertebrae and return them to their previous shape. Modern methods of eliminating compression are kyphoplasty and vertebroplasty.

A number of tips will help you avoid exposing yourself to the risk of getting a compression fracture of the spine:

1. Be careful at home, in the workplace, and while relaxing in nature;
2. Try not to violate traffic rules on the road;
3. Eat right, especially in old age, eat less fried and salty foods;
4. Strengthen your back muscles with regular gymnastic exercises;
5. Treat inflammation, tumors, and bone tuberculosis in a timely manner.