Compression fracture of the spine in a child: an invisible threat. How to treat a compression fracture of the spine What massage is done after a spinal injury

During a spinal fracture, the integrity of its structural elements – the vertebrae – is compromised. The mechanisms of vertebral fracture can be different. These are flexion-extension (flexion-extension), rotation (rotation around the longitudinal axis) and compression (compression, squeezing) of the vertebral bodies and arches. Moreover, the last type, compression fracture of the spine, is the most common in clinical practice. This same pearl is the most dangerous in terms of possible complications.

Causes

In order for a compression fracture of the spine to “successfully” form, at least one of two factors must be present. This is an external influence, the strength of which exceeds the strength of the bone tissue of the vertebrae, or the initial weakness, failure of this tissue. Most often, the first option occurs - injuries, the main causes of compression fractures of the vertebrae.

The mechanism of injury may be different. Most often this is:

• Falling from a height onto your back;
• Falling from height onto legs or buttocks;
• Strong blow to the back;
• Falling from a height onto the back of a heavy object;
• Hitting the head while diving, or “diver’s injury,” is the most common cause of compression fractures of the cervical spine.

Under certain pathological conditions, a change in the structure and a decrease in the density of the bone tissue of the vertebrae is possible. In these cases, to obtain a compression fracture, a minimal external impact is sufficient, which is absolutely not dangerous for healthy people. Such compression fractures are called pathological. Most often they are a consequence of osteoporosis - a decrease in the strength and density of bone tissue. Sometimes tuberculous and tumor lesions of the vertebrae can lead to pathological compression fractures.

Symptoms

A distinctive feature of a compression fracture of the spine is a decrease in the height of the vertebral body under the influence of compression. It is this feature that forms the basis for the classification of compression fractures. According to this classification, there are 3 degrees of compression fracture:

First aid for a spinal fracture

• 1st degree fracture – the height of the vertebral bodies has decreased by less than 30% of the original;
• Grade 2 fracture – height decreased by more than 30%, but less than 50%;
• Grade 3 fracture – a decrease in vertebral height by more than 50% of the original.

Along with the vertebral bodies, their arches are often affected by a compression fracture. Compression fractures can be single or multiple, respectively, with damage to one or more vertebrae. In addition, a distinction is made between stable and unstable compression fractures. In the first case, intact and damaged vertebrae do not move relative to each other, and the overall structure of the spine is not disturbed. With unstable compression fractures, the vertebrae are displaced and the so-called fracture-dislocation

The main symptoms of a compression fracture of the spine:

• Pain at the fracture site;
• Visible deformation of the spine;
• Local soft tissue swelling;
• Limitation of volume or complete absence of movements in the spine;
• Abrasions or bruised skin wounds in the area of ​​the fracture.

With a compression fracture, along with the vertebrae, other structures are affected - spinal ligaments, intervertebral discs, muscles, blood vessels with the development of bleeding of varying severity.

Neurological complications

This is how a wedge-shaped deformity of a vertebral body with a compression fracture looks schematically

But the main danger with a fracture is not damage to the vertebrae, or even possible bleeding. As a result of compression, a wedge-shaped deformation of the vertebral bodies is formed, which in the longitudinal section takes the shape of a wedge - a triangle, with its base facing the spinal canal. Such a vertebra moves towards the canal and damages the spinal cord located there. Unstable compression fractures are especially dangerous in this regard.

The degree of damage to the spinal cord can vary - from a concussion or bruise to a complete rupture in the cross section. And, the higher the level of damage, the more severe the neurological manifestations. A compression fracture of the lumbar spine can lead to paralysis of both lower extremities (lower paraplegia) and loss of control of the pelvic organs. True, in adults there is no spinal cord substance below the 1st lumbar vertebra. But here passes a powerful nerve bundle, the so-called. cauda equina, which supplies sensory and motor fibers to the skin, muscles, pelvic organs, and lower extremities.

A compression fracture of the thoracic spine and concomitant damage to the spinal cord, along with the previous symptoms, occurs with difficulty breathing, decreased sensitivity in the chest, back and abdomen, and impaired tone of the diaphragm. And if the spinal cord is damaged in the cervical region, all muscle groups of 4 limbs (tetraplegia), abdomen, and chest are disabled. This leads to difficulty breathing and the need to transfer the patient to artificial ventilation.

This is what a vertebral deformity looks like on a CT scan:

Treatment

A patient with a spinal compression fracture should be treated immediately after receiving the injury. Correct and timely transportation to a specialized medical institution is also a type of treatment. Mistakes at this stage can be costly. The displacement of fragments at the stage of travel to the hospital can lead to neurological complications even in cases where they were not present initially. To prevent complications, the patient is placed on his back (not on his side or stomach) on a flat, hard surface.

At the hospital, the doctor will conduct diagnostics - an external examination, radiography and computed tomography of the spine. Painkillers are required - Ketanov, Analgin, Renalgan. With concomitant spinal cord injury, specific drugs are used that improve blood circulation and metabolic processes in the spinal tissue - Pentoxifylline, Trental, Actovegin.

Even in the absence of spinal cord injury, patients with a compression fracture are advised to remain on strict bed rest for the first few weeks. Subsequently, minimal physical activity is allowed. In this case, the patient is recommended to mainly stand or walk - not sit. At this time, wearing a special corset is indicated. The corset stabilizes the damaged spine through immobilization (immobilization). You need to use the corset for at least 2 months. from the moment of injury.

For compression fractures of the cervical vertebrae, a Shants collar is used as an immobilizing device.

After 1.5 months. Rehabilitation should be carried out from the onset of injury. A light massage and physiotherapeutic procedures are carried out - UHF, magnet, electrophoresis with calcium. In the absence of complications and severe concomitant diseases, complete consolidation (fusion) of broken vertebrae occurs in approximately 3 months. After this, restoration is carried out within six months. Courses of massage and physiotherapeutic procedures continue. In order to strengthen the back muscles and expand the range of movements, gentle physical activity is recommended as part of physical therapy.

Video about the causes and mechanisms of development of spinal compression fractures:

Compression fractures of the 3rd degree, severe comminuted fractures of the vertebral bodies, and concomitant injuries to the spinal cord are indications for surgical intervention. During the operation, decompression is performed - fragments of the vertebral bodies are removed, and, as far as possible, the function of the spinal cord is restored. To ensure the integrity of the vertebrae, various methods of spinal plastic surgery (vertebroplasty) are performed, including those using modern synthetic materials that can replace damaged bone tissue.

How is a spinal fracture treated?

A compression fracture of the spine is one of the most complex injuries that occurs when the spine cannot cope with the vertical compressive load pressing on it. Treatment of a compression fracture of the spine is also difficult and is carried out in several periods. But the main thing that distinguishes such treatment from conventional treatment is long-term rehabilitation, the duration of which depends on the severity of the injury. Why this is so can be understood by knowing the anatomy of a compression fracture and the full clinical picture that occurs with it.

A compression fracture occurs when the spine is simultaneously compressed and tilted forward.

Treatment of spinal compression fracture

In general, the spine copes well with its function as a shock absorber, but sometimes extreme situations arise when the strength of a vertebra or even several is insufficient - then a fracture occurs:

1. When falling, and not always from great heights.
   The proof is a huge mass of fractures when falling from a height of only 0.5 to 1.5 m.
2. During a car accident
3. With the critical development of spinal diseases leading to bone tissue degeneration:
   • osteoporosis, primary tumors, metastatic lesions of the spine, bone tuberculosis and other diseases

What is the mechanism of the resulting fracture?

A fall or a sharp blow, such as a whiplash injury, simultaneously compresses and bends the spine forward. This “fatal” moment is enough to lead to irreparable consequences: wedge-shaped fractures of the vertebrae at the bending point. The displacement can provoke the release of the fragment towards the spinal canal and, in the case of pressure on the spinal cord, cause dangerous syndromes, including paralysis and failure of some organs.

The most “unfavorable” one is a compression fracture of the spine in the cervical region, since it is fraught with respiratory paralysis, and if the spinal cord is ruptured, a person faces almost complete immobility.

A fracture of even one vertebra disrupts the stability of the spine, due to which the spinal column acquires unnatural kyphosis, manifested in the form of a hump, which is especially visible with a compression fracture of the thoracic region

The standard scheme relates the degree of fracture to the nature of the spinal injury:

• Light fractures – the integrity of the vertebra is partially broken, the injury is stable (the position of the vertebrae relative to each other is not disturbed)
• Fractures of moderate severity - destruction of the vertebra is significant, the injury is unstable, but the spinal cord is intact
• Severe fractures – accompanied by multiple fractures and dislocations, spinal stability is pronounced, spinal injury is possible

Treatment Steps for Compression Fractures

Treatment of any compression fracture of the spine is carried out urgently from the very first minutes, since it is impossible to immediately assess the degree of its complexity

First step: emergency help

When providing first aid, you must immediately immobilize the area of ​​injury using bandages, corsets, and handy tools.

Immediate hospitalization and delivery of the patient to the hospital are carried out with simultaneous first aid:

• ensuring immobility of the injury site using bandages, corsets, and improvised means
• preliminary assessment of the patient’s condition using special tests (pressure, pulse, sensitivity, pupils, etc.)
• monitoring vital signs (respiration, circulation)
• recovery from shock (in case of severe injuries), pain relief

The second step is a detailed diagnosis:

1. Using X-rays, in at least 2 projections, it is determined which part of the spine is damaged
2. Identified damaged vertebrae are examined using CMT to determine the full clinical picture of the fracture
   Additionally:
3. An MRI or myelography is performed if symptoms of myelopathy and the release of a vertebral fragment into the spinal canal or tumor formations are noticed
4. Densitometric examination - in case the fracture occurred under an inadequately small load, and the age of the victim exceeds 50 years. Based on the degree of bone density, such a study allows diagnosing osteoporosis.

The third step is the main phase of treatment

• Restoring spinal stability and anatomically correct curves
• Reconstruction of broken vertebrae
• Treatment and prevention of complications

Spinal stability can be restored with traction, which is carried out in two ways, depending on further treatment:

• In one step, if the next step is surgery to restore or replace a vertebra
• With the help of reposition - a gradual (day by day) increase in the angle of inclination of the orthopedic bed. Performed if surgery is not needed

Choice of fracture treatment methods

• Mild injuries are treated mainly conservatively. To restore the vertebrae, a corset is put on the affected area for a period of 3–4 months.
• For moderate injuries, the possibility of using both conservative and surgical methods is approximately the same. Traction is often considered an alternative to surgery
• Severe injuries usually require surgery

Types of operations for compression fractures of the spine

Treatment of complications

Treatment of spinal compression fractures is a long and painful process, so it is not without complications. The reason for them:

• prolonged immobility in the affected area
• neuralgic and visceral-vegetative disorders

If the injury is complicated by damage to the spinal cord, then the period of being in a horizontal position is even more extended.

Treatment of possible complications is carried out approximately in the following areas:

1. Fighting bacterial and purulent infections with antibiotics
2. Prevention of thrombus formation by using anticoagulants:
   • Heparin, dicoumarin, etc.
3. Acceleration of metabolic processes that promote wound healing:
   • steroid hormones
   • riboxin
   • Potassium orotate
4. Improvement of nervous activity:
   • piracetam, actovegin, etc.
5. Taking vasodilators and drugs that increase the elasticity of the walls of blood vessels
   • vitamin C, rutin, troxevasin
6. Treatment of neuralgic and autonomic symptoms such as:
   • pain, loss of sensation, muscle atrophy
   • gastrointestinal ulcers and gastritis
   • trophic ulcers and bedsores, etc.

Fourth step:

Rehabilitation after a compression fracture

Rehabilitation is no less important than treatment. It depends entirely on her:

• Will spinal stability be restored?
• Will motor activity return to full extent?

All this will entirely depend on the quality and duration of the rehabilitation period.

Important rule:

The duration of the rehabilitation period depends on the severity of the injury and is equal in time to the duration of treatment

If you were treated for three months and wore a corset all this time, then rehabilitation will last the same amount.

The main method of rehabilitation is exercise therapy (physical therapy). After a long period of immobility in a corset, the freed spine needs enhanced development.

Exercise therapy for minor injuries begins in the first days after the injury.

Exercise therapy, like treatment, is divided into several stages, three of which are carried out in a lying position.

A cushion is placed under the injured area before performing exercises.

For minor fractures, exercise therapy begins from the very first days after the injury

1. The first stage of exercise therapy (the first 2 weeks after a compression fracture) consists of simple static and motor exercises in a supine position, the purpose of which is to prevent muscle atrophy, normalize breathing and heart function.
   For example:
   • We bend and extend the hands, arms at the elbow joints, feet
   • Circular rotations of the feet
   • We tense the muscles of our hands and slowly clench them into fists.
   • Bend your knees and slide your feet one by one
   • Deep breathing with the diaphragm: exhale slowly, longer than inhale. At the end of exhalation, hold your breath for a few seconds
2. The second stage of exercise therapy (next 2 weeks) is designed to improve blood circulation, normalize the functioning of internal organs and further strengthen muscles and ligaments. Exercises while lying on your stomach are allowed
   • Abduction of arms to the side, raising of arms, rotation of arms
   • Leg bending at the knee and straightening with lifting
   • Alternating leg movement "bicycle"
   • Lying on your stomach, spread your arms to the side
   • Raise your head and shoulders
   • Isometric exercises:
     We alternately strain the muscles of the shoulder girdle, back, buttocks, thighs and legs, without making any movements with them
3. The third stage of exercise therapy begins a month after the injury and lasts from 2 to 4 weeks. Its tasks include strengthening the muscles of the trunk and pelvis and preparing the spine for axial loads
   • Exercises are done with resistance and weights (with the help of an instructor and a rubber band)
   • Added crawling on all fours on the bed
4. At the fourth stage of exercise therapy, which begins 1.5 - 2 months after the compression fracture, an important event occurs: it is allowed to get out of bed. Exercises during this period are aimed at adjusting the spine to a vertical position and restoring motor activity:
   Added standing exercises with emphasis on the headboard:
   • Raising and abducting legs
   • Shallow bends
   • Heel-to-toe rolls

This stage of exercise therapy can last from one to two months, continuing after discharge. It can be combined with physiotherapy.

Video: Rehabilitation and treatment of spinal compression fracture

How to treat a compression fracture of the spine

Lumbar spinal stenosis http://pozprof.ru/bn/ctenoz.html#t2.

Operation

Surgical treatment of compression fractures of the spinal column is indicated for compression of nerve structures (spinal cord, nerve roots), instability of the spinal column, and severe pain. For example, when the height of the vertebral body on radiographs decreases by more than 50%, spinal instability occurs, which can lead to compression of the neural structures. In this case, surgery is needed to prevent injury to the nerve roots and spinal cord. There are several types of operations that are performed for compression fractures of the spine. Depending on the type of vertebral fracture and the severity of compression of the nerve endings, the doctor may choose one or another type of operation. The basic principles of surgery for spinal injuries are the removal of compression of the nerve structures (if there are symptoms of compression of the spinal cord or nerve roots by the bone structures), as well as stabilization (fixation in a physiologically advantageous position) of the damaged spinal segment.

Anterior access. When the spinal cord is compressed from the front by a crushed vertebral body, the surgeon usually performs the operation from the anterior approach. In this case, the incision is made on the anterolateral surface of the abdomen or chest. The body of the damaged vertebra is then exposed. The bone elements compressing the bone marrow are removed. After decompression, the spinal column is stabilized. To do this, a bone graft is attached to the site of the removed destroyed vertebral body. Today, grafts made from the patient's own bone (autografts), as well as from specially treated cadaveric bone (allografts), are widely used. Cages - artificial prostheses of vertebral bodies or discs - are becoming increasingly popular for stabilizing the spine. Cages are made from durable artificial materials or titanium. The cage is filled with bone chips, which are taken from the crest of the pelvic bone, using a special cutter. After a few months, the graft consolidates with the bodies of the underlying and overlying vertebrae into a single bone structure (conglomerate). To fix the graft and the damaged spinal segment in a physiologically correct position, stabilizing systems are used, which can consist of plates, screw bridges and beams. The components of stabilizing systems are made of titanium or alloys (titanium carbide) - durable, inert (non-active) materials that do not cause a rejection reaction from the body.

Rear access. Often, spinal stabilization can be achieved through a skin incision in the back (posterior approach). This operation using a posterior approach is most often performed in the absence of dorsal anterior compression of the spinal cord by areas of the damaged vertebral body. Internal fixation of the damaged spinal segment in a physiologically correct position using special stabilizing systems helps prevent damage to nerve structures (spinal cord or roots), ensure early activation of the patient, and help optimal fusion of bone structures. Most often in recent years, transpedicular stabilization of the spine has been used in surgical practice. With this technique, locking screws are secured through the vertebral pedicles into the vertebral body. The screws on each side are connected by strong beams that unite the vertebrae into a single conglomerate. These stabilizing systems differ from others in their great strength and reliability, which allows the patient to be activated from the first days after surgery.

Source vertebra.su

Exercise therapy

Exercise therapy for a compression fracture of a vertebra of the thoracic or lumbar spine is one of the main methods of rehabilitation of patients with these injuries to the musculoskeletal system. The main advantage of physical therapy is its high efficiency. Well, the minimal cost serves as an additional argument in favor of the widespread popularization of exercise therapy at all levels of the treatment and recovery process.

Exercise therapy for a compression fracture of a vertebra in the thoracic or lumbar spine is primarily aimed at increasing the strength and endurance of the trunk muscles, and subsequently at increasing the mobility of the spine. In addition, exercise therapy for vertebral compression fractures is part of preventive measures aimed at preventing the formation of bedsores, reducing the phenomena of general asthenic syndrome, preventing thrombus formation and normalizing digestive processes.

Timely and sufficiently long implementation of a complex of physical therapy for injuries of the thoracic and lumbar spine prevents the development of congestive pneumonia and/or the development of pelvic organ dysfunction.

Source medstrana.com

Introductory part: starting position (i.p.) - lying on your back.

Spread your arms to the sides - inhale, arms forward and down - exhale. 8-10 times.

Slowly bend your arms at the elbow joints with tension, bringing your hands to your shoulders. 8-10 times. Dorsal and plantar flexion of the feet. 8-10 times.

Moving your arms to the side while simultaneously turning your head in the same direction. Raise your hands - inhale, lower them - exhale. 8-10 times.

Bend your leg at the knee joint, stretch it up and lower it. 11-15 times.

Abduction and adduction of the straight leg. 8-10 times.

Straight arms are spread to the sides at shoulder level and slightly pulled back. Small circular movements of the arms with some slight tension in the muscles of the back and shoulder blades. 8-10 times.

Arms bent at the elbows with emphasis on the bed. Bending in the thoracic spine with support on the elbows and forearms. 8-10 times.

Hands on hips. Simulation of cycling. Move your legs only alternately! 8-10 times.

Isometric tension of the thigh muscles 5-7 sec. 5-6 times.

Clenching and unclenching the fingers. 12-15 times.

Raise your straight leg to an angle of 45 degrees and hold it for 5-7 seconds. 4-5 times.

Diaphragmatic breathing. 5 times.

Isometric tension of the lower leg muscles 5-7 sec. 4-5 times.

Raising your arms up through your sides - inhale; return to the starting position - exhale. 6-8 times.

I. p. - lying on your stomach.

Arms bent at the elbows, forearms on the plane of the bed. Bending of the torso in the thoracic region. 6-8 times.

Raising your head and shoulders. 8-10 times.

Alternating abduction of the straight leg. 8-10 times.

Isometric tension of the back muscles 5-7 sec. 5-6 times. Passive rest - 2-3 min.

I. p. - standing on all fours.

Alternately abducting straight arms to the sides. 8-10 times.

Alternately raising your arms up, while simultaneously raising your head and arching your back. 8-10 times.

Alternate circular movements with your hands. 8-10 times.

Alternating straight leg raises. 8-10 times.

Raising a straight arm up while simultaneously raising an opposite straight leg. 8-10 times.

Moving on all fours forward and backward.

Moving on your hands to the right, left, legs remaining in place - the so-called “bear step”.

Duration of classes is 40-45 minutes.

Always watch your posture! You can sit after 3-3.5 months, for a short time, several times a day. Bend forward is prohibited until 3.5 months. Subsequently, classes in the pool (preferably daily). Observation by a traumatologist for up to 6 months.

Source dreamsmedic.com

Gymnastics

In the complex of rehabilitation treatment tools used in the process of medical rehabilitation of patients with consequences of injuries and diseases of the spine, therapeutic exercises play a leading role.

The use of physical exercises for therapeutic purposes is carried out in accordance with the method of rehabilitation therapy for this disease and its individual manifestations in individual patients.

Complexes of physical exercises and separate special exercises are selected taking into account the nature of the injury, the period from the moment of injury or surgery, age, clinical features of the disease, etc.

The dosage of load when applying physical exercises, the choice of starting position and various types of therapeutic exercises should vary depending on the individual characteristics of the patient and the course of the disease.

Source argo-moscow.com

Kneading massage for compression fracture of the spine. This procedure helps:

strengthening the back muscles; giving them tone; preventing the formation of bedsores.

During the period of immobilization, to prevent bedsores, the area of ​​the sacrum, buttocks, and back is stroked and rubbed with camphor alcohol, placing rubber circles under them.

Massage is prescribed in the subacute period (after 5-6 weeks). First, massage the chest (all techniques gently), then the back (stroking and rubbing), the stomach (all techniques) and limbs. In the spastic form of paralysis (paresis), planar and circular stroking, superficial grasping stroking, longitudinal kneading and felting are used for muscles with high tone, and for antagonist muscles - stroking, rubbing, transverse kneading, and tapping. For peripheral paralysis, kneading, twitching, moving muscles, rubbing tendons and joints are used. The massage procedure lasts 10-20 minutes daily or every other day, 10-12 procedures.

Source smdoctors.ru

Diet

In the diet of a patient who has suffered a compression fracture of the spine, preference should be given to foods high in the following microelements and vitamins:

Calcium. It is found in dairy products, almonds, cabbage, and salmon fish.

Magnesium. There is a lot of it in nuts, leafy vegetables, bananas, and shrimp.

Zinc. Seafood contains a lot of zinc; there is zinc in buckwheat and oatmeal, and walnuts.

Folic acid and vitamin B 6. Contained in liver, bananas, beans, cabbage, beets.

All these vitamins and microelements contribute to the rapid formation of callus and fracture healing.

There is also a list of foods that should be excluded from the diet of patients with fractures. This:

Coffee, strong tea, lemonade. Caffeine promotes calcium leaching.

Fatty foods. Fat prevents calcium from being absorbed properly.

Alcohol. It disrupts the functioning of cells and promotes their destruction.

In conclusion of the article, I would like to say a few words about the prevention of compression fractures. First of all, this means being careful when playing sports and active recreation, and in old age – preventing and treating osteoporosis. And, of course, a diet rich in calcium!

Source moyaspina.ru

Compression fracture of the spine: treatment and rehabilitation

The spine is a support, the basis for body movements, and protection for the spinal cord. The vertebrae are made of bone tissue, similar in structure to a sponge. If you simultaneously put a load on the spinal axis while bending the spine, strong pressure or compression occurs. The vertebra becomes wedge-shaped, the height of its anterior section decreases. A compression “burst” fracture is more dangerous, when a part of another vertebra is pressed into the body of one vertebra and the destruction of cancellous bone tissue begins. But with osteoporosis, when the spine has low bone density, a fracture can occur even due to a small load. Why a compression fracture occurs, how it is treated and what to do next, read on.

Causes of compression fracture

Injuries to the spine can be caused, for example, by falling from a height (especially on your feet), lifting heavy objects, as well as car accidents with strong blows to the back. Also a factor in frequent and dangerous fractures is osteoporosis - a weak bone cannot withstand the load and breaks (especially often after menopause and in old age).

What are the types of compression fractures?

Experts divide a simple compression fracture into three degrees. In the first degree, the height of the vertebral body decreased slightly, in the second – by half, and in the third – by more than half. Spinal canal injuries are classified as complex fractures. In this case, the vertebrae may move out of place and dislocate. The bone tissue of the vertebra sometimes damages the nerve roots and is pressed into the spinal cord canal.

Symptoms of a compression fracture

First of all, pain is felt in the back, severe at the time of the fracture, and then a constant aching (becomes stronger while walking or sitting for a long time). Depending on the location of the fracture, pain may be felt in the arm or leg (they often feel numb). With osteoporosis, compression is gradual, pain increases over time. In addition, the muscles near the spine become painfully tense (this condition is called the “reins symptom”). If there are many fractures, shock sets in, the skin turns pale, and sweat appears. A complicated fracture can lead to paralysis and even death.

How to provide first aid?

If you suspect a vertebral fracture, you must remain motionless (until the ambulance arrives); you must not sit down or stand up. You can be transported carefully on a rigid stretcher or shield so that the axis of the spine does not shift. It is recommended to place a soft cushion under the injured area. If the stretcher is not rigid, it is better to lie on your stomach.

Diagnosis of a fracture

A compression fracture should be diagnosed as early as possible. The specialist conducts an examination, assesses the condition of the spine and spinal cord. An x-ray of the possibly damaged part of the spine is prescribed. Additionally, a computed tomography may be performed. To find out whether the spinal cord is damaged at the fracture site, a myelogram is done. If nerve injury is suspected, a magnetic resonance imaging scan is performed. For women over fifty years of age, bone density is determined through osteodensitometry.

How is a compression fracture treated?

The first and second degrees of fractures are treated conservatively, but the third and complicated ones are treated with surgery. Conservative treatment methods include pain relief with movalis, diclofenac, ketoprofen, arcoxian, nise and other drugs. Cold applied to the fracture site for 15 minutes (four to five times every 15 minutes) helps relieve pain. In case of severe pain, the doctor injects 15-20 ml of 0.5% novocaine on both sides of the spine.

You can unload the spine by lying on a hard surface with your legs tilted at 30 degrees and a bolster under your back in the area of ​​the fracture. Bed rest is needed for one to two months (depending on the severity of the fracture). You cannot do without traction with Gleason's chin loop in case of injury to the cervical spine. Then the spine is fixed with a special rigid corset, which supports the back and prevents compression of the broken vertebra with slight extension. But if the broken vertebra is fixed transpedicularly (installation of lumbar screws), a corset is not needed. Experts prohibit sitting and standing for long periods of time during treatment. Bed rest and a corset are complemented by physiotherapy (treatment with a magnet, laser, electrophoresis, UHF, currents) so that blood circulation becomes more active, pain goes away and recovery goes faster.

With severe compression, the height of the vertebrae is adjusted in several ways. The first method is called vertebroplasty - special bone cement is injected into the vertebra to restore its shape. Using kyphoplasty, the surgeon corrects the shape and position of the vertebra (fixation with cement). These techniques are minimally invasive. Small incisions are made, and a miniature video camera is attached to the inserted endoscope so that you can see what is happening to the spine and monitor the operation. A complex fracture is operated on openly. The neurosurgeon must remove vertebral fragments that put pressure on the spinal cord with nerve roots. The vertebra is then fixed with a metal structure. If necessary, the vertebra is filled with bone cement.

How is recovery after a fracture?

After an uncomplicated fracture, physical therapy is recommended as early as possible. The first week begins with breathing exercises and movements of the joints of the arms and legs. Over the course of a month, the exercises become more complex - the main thing is to strengthen the muscles of the back, arms and legs. Roll over in bed, you can raise your legs to an angle of about 45 degrees, keep them suspended, then lower them. When you start walking a month or two after the injury, the exercises are done on your knees; you need to walk for 15 minutes at first. A back massage is prescribed. Three and a half to four months after the control x-ray of the spine is taken, you can sit down for five to ten minutes several times a day, gradually increasing the time (using unloading circles with special pillows). Bends of the body forward, exercises in water, and spa treatment are effective. Depending on the severity of the injury, a person is considered disabled from four months to a year. For several years you should not put shock loads on your back, that is, run, jump, or carry heavy loads. After transpedicular fixation, you do not need to wear a corset; exercise therapy (exercises for arms and legs) can be done two to three days after the operation. After ten days, strengthening of the back muscles begins, lying on your stomach or kneeling. Gymnastics become more difficult after a month. Less time off work.

The danger and consequences of a compression fracture

After an injury, osteochondrosis and hernias may develop. After a fracture, the height of the vertebral body is disrupted, which means the motor capabilities of the vertebrae change - they become more mobile relative to each other and, as a result, deform faster. An osteoporotic fracture in the thoracic region is fraught with persistent deformity of the spine or kyphoscoliosis (in this case, constant pain is felt, shortness of breath appears with fatigue, the stomach and heart do not work properly. The most severe consequences of a fracture include paralysis - surgery with a long recovery is indicated. Experts remind that the consequences can manifest themselves not immediately. Bone fragments make the canal in which the spinal cord lies narrower, so that nerves can be damaged. This is dangerous due to stenosis - numbness in the arms or legs, weakness in the muscles. If you notice these and other symptoms, consult a doctor immediately.

Compression fracture of the spine - symptoms, diagnosis and treatment

A compression fracture of the spine is one of the most serious injuries, in which compression of the bodies of one or more vertebrae occurs. Very often, this type of injury occurs when jumping from a great height and landing on your feet and with increased flexion of the torso. The most common localization of this type of fracture is the lower thoracic and lumbar regions (compression fracture of the spine - photo). Compression fracture of the spine - its consequences can be very serious. Firstly, if the vertebral body is pressed into the lumen of the spinal canal, this can lead to compression of the spinal cord, destruction of the intervertebral disc and to paresis and paralysis of the limbs.

According to the existing classification, compression fractures differ in the presence of complications and the degree of change in the shape of the vertebra. The diagnosis of a compression fracture of the spine of the 1st degree means that there is a decrease in the height of the vertebral body by approximately one third, a compression fracture of the spine of the 2nd degree indicates a decrease in this height by about half.

In the first case, a spinal fracture can be treated without much difficulty; the most important thing is to react promptly and seek help from a doctor in a timely manner. An experienced doctor, when palpating the spine, will be able to accurately determine in any area that there is damage and will offer the most appropriate and safe treatment in each specific case.

Compression fracture of the thoracic spine

A spinal fracture in the thoracic region has its own characteristics. The clinical picture will be associated primarily with difficulty breathing at the time of injury; even a temporary stop (apnea) may be observed. The pain is usually not very severe in the projection of the affected vertebra. the pain may intensify with load along the axis of the spine, movements will also be difficult, and in some cases completely impossible.

After an injury, the back muscles will experience prolonged tension, and the pain may radiate to the abdominal area. Neurological symptoms may occur, but fortunately this does not happen often. By palpation, you can accurately determine the damaged vertebra, and you will feel increased pain in this area. This is the main thing you need to know if you want to determine if you have a fracture in the thoracic region.

Compression fracture of the lumbar spine

A lumbar spine fracture can also cause difficulty breathing. The muscles in the affected area are tense and the victim cannot turn the body. Signs of a lumbar spine fracture can sometimes be accompanied by neurological disorders in the form of severe headache, nausea and vomiting, loss of consciousness and some others.

Compression fracture of the spine in children

In children, compression fractures are considered the most serious injuries to the spinal column, although they account for no more than 1-2% of cases of all spinal injuries, but if treated incorrectly they can lead to disability. This is due to the anatomical and physiological characteristics of the growing organism - the child’s spine has higher flexibility than that of an adult, due to the greater height of the intervertebral discs, the strength of the ligamentous apparatus and mobility at all levels of the spinal column. One of the most common causes of compression fractures in children is a fall from a height (garage, tree or swing, jumping into the water from a springboard).

Causes of spinal compression fractures

A compression fracture of the spine is associated with excessive mechanical stress on the vertebral body. The tissues of the vertebral body are destroyed and compressed, as a result of which it acquires a wedge-shaped shape. There are several causes of such compression fractures. One of the most common causes is osteoporosis. This disease is systemic and leads to a decrease in bone mass, as a result of which the bones become more fragile and can no longer withstand even normal loads. Eventually, a fracture can occur even with normal forward bending. A compression fracture caused by osteoporosis leads to decreased height and the formation of pointed kyphosis (hunchback), especially for older people.

Compression fracture of the spine - symptoms

In cases where a compression fracture of the spine is caused by a sudden injury, the first symptom will be a sharp piercing pain in the spine. At the same time, you may experience a feeling of weakness and numbness in the limbs if the fracture is associated with damage to the nerve structures of the spine. If the destruction of the vertebra occurs gradually (often observed in osteoporosis), then the pain will be moderate.

Diagnosis of spinal compression fracture

Before a specialist can make a diagnosis and decide on treatment tactics, he must collect your medical history (the history of how and when this happened to you). It is very important to distinguish a compression fracture from other diseases that may also be accompanied by severe pain. To confirm the diagnosis and determine the correct treatment tactics, the doctor may prescribe a set of additional diagnostic procedures. For example. You may need to be examined by a neurologist to check the function of the spinal cord and nerve endings.

An X-ray examination will help more accurately determine the location of the damage.

A computed tomography scan may also be prescribed to study the structure of the damaged vertebra in fine detail. If necessary, along with computed tomography, myelography can be prescribed to assess the condition of the spinal cord. MRI is most often performed when damage to the nerve structures of the spine is suspected. When diagnosed with a compression fracture of the spine, all middle-aged women must undergo densitometry to exclude osteoporosis.

Compression fracture of the spine - treatment

How to treat a compression fracture of the spine, you ask. After a set of necessary diagnostic procedures has been carried out and a diagnosis has been established, a treatment and rehabilitation plan is drawn up. It is worth remembering that a compression fracture of the spine requires long-term treatment, including strict adherence to the regimen and self-discipline. Treatment must be carried out under the close supervision of a doctor. The choice of treatment method will be determined by the severity of the disease and the patient's condition. For mild fractures, conservative treatment is generally used, while for severe fractures, surgical treatment is likely to be required.

Conservative treatment

Conservative therapy includes pain medication and a set of physical exercises. At the first stages of treatment, the patient is placed on a special hard bed, which must also be inclined, and physical activity is completely eliminated for a while, so that the spine has the opportunity to recover. At the next stages of treatment, you can use massage for a compression fracture of the spine, special exercises for a compression fracture of the spine, and physiotherapeutic procedures.

Depending on the time that has passed since the injury, age characteristics and the nature of the disease, exercise therapy is used for a compression fracture of the spine. Gymnastics for a compression fracture of the spine helps restore the axis of the spine and its natural curves, strengthen the muscular corset of the back and torso, restoring normal mobility and flexibility of the spine. After six months of training, the normal performance of patients who have suffered a compression fracture of the spine is usually restored.

It is also recommended to wear a corset for a compression fracture of the spine, which will help speed up recovery after the fracture and create additional fixation for the spine. To achieve the effect, you need to wear a corset for at least two months. In complex cases of spinal fractures, radical treatment methods may be required; for fractures that are associated with damage to nerve structures, open surgery will be required.

Compression fracture of the spine - rehabilitation

Rehabilitation after a compression fracture of the spine, if there is no damage to the nerve roots, has as its goal the return of people to normal life. Recovery after a compression fracture of the spine mainly involves the use of physical therapy, but not earlier than a month or a month and a half after the injury. Electrical stimulation, cryotherapy (cold treatment) and massage are sometimes used to relieve pain. Thanks to physiotherapeutic procedures, correct posture is restored, mobility and flexibility of the spine improves.

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Compression fracture of the thoracic spine: treatment, exercise therapy, consequences, etc.

Symptoms

When a person experiences a compression fracture of the thoracic spine, the first thing that bothers them is pain. As a result, motor activity is impaired and the limbs may become numb. Increased pain can be provoked by coughing or small movements, even breathing.

If you palpate the area of ​​damage, you will notice a sharp pain, the muscles are tense. Often a hematoma can be seen above the site of injury; it can reach significant sizes.

All symptoms should alert you and make you see a doctor.

Diagnostics

Compression fracture of the thoracic spine on x-ray

First of all, all the data is collected from the person, especially how he got injured and what happened after that. Be sure to pay close attention to the neurological status, whether there is numbness or impaired motor activity. X-rays can clarify the location and nature of the damage; in some cases, CT or MRI is required to identify damage to the spinal cord.

Treatment

The treatment process is not as fast as it might seem at first glance. In case of a minor or uncomplicated fracture, conservative treatment is indicated, but when the spinal cord is at risk or the vertebra is significantly destroyed, then surgery simply cannot be avoided.

Only a doctor can treat a spinal fracture!

A corset is one of the ways to treat a fracture

Conservative treatment includes taking medications aimed at reducing pain. Bed rest and being on a hard bed are of no small importance. Additionally, the doctor may prescribe wearing a corset, and then, at the rehabilitation stage, physiotherapy and physical therapy in combination with massage.

It is worth understanding that taking analgesics will not cope with the essence of the problem, but will only reduce the pain. Only time and peace can help, and only with an uncomplicated fracture. The healing time for thoracic vertebral fractures is approximately 14 weeks. During this period, any type of physical activity is prohibited; it will contribute to deformation of the vertebral body. Bends and turns of the body and lifting of loads are prohibited. The basic thing is to stay in bed for several weeks.

The duration of healing of a compression fracture of the thoracic vertebra is approximately 3 months. X-rays are taken every month to monitor the degree of fusion.

The operation and its volume depend on the degree of damage; the most commonly used is kyphoplasty, a technique that involves introducing a special substance into the vertebral body and restoring its normal height. It is possible to supply a metal structure; it performs the function of decompression when the spinal cord is compressed. The vertebral fragments are removed, and then the vertebrae are fixed with metal.

Rehabilitation after a fracture

Rehabilitation after a compression fracture of the spine includes physical exercises

It is not without reason that there is an opinion that any, even the most brilliantly performed operation, is nothing without competent rehabilitation. It’s not enough to just operate on a person; it’s worth getting him back on his feet and giving him the opportunity to live a full life.

Physical therapy is exactly what helps you recover from injury. The whole process is divided into four stages:

• In the first week or week and a half, all efforts are aimed at reducing muscle tension and restoring the activity of internal organs.
• After, but no later than a month after the injury, exercises are indicated to help restore blood circulation. It is necessary to strengthen the muscles, especially the back, pelvic and shoulder girdles. During this period, it is important to create a strong muscle corset.
• In the period from 40 to 60 days, exercise therapy involves the use of exercises with a gradual increase in load and the presence of weights. The duration of the workout gradually increases.
• In the fourth period, which begins two months after the injury, loads on the spinal column in a vertical position are shown. Swimming helps effectively.

It is very important not to start gymnastics without the advice of a doctor or specialist, as this can only make things worse and harm your health. It’s better not to be lazy, find a set of exercises, print it out and show it to a professional.

Gymnastics at different stages of treatment

Depending on the period, a different set of exercises is used, which prepares the body for more complex loads.

At the first stage, the easiest complex is used, in which the starting position is horizontal on the back with the arms located along the body. They start with diaphragmatic breathing, which will require a bag of sand weighing one and a half kilograms on the stomach. During inhalation, the load rises higher and at this stage the breath is held for about 5-10 seconds. During exhalation, the weight lowers. The exercise is performed 4 to 6 times.

A good effect is obtained by squeezing and unclenching the fingers, extending and bending the feet, elbows, wrist joints, and circular movements. After straight arms are moved to the sides at shoulder level and brought back, the task is to perform circular movements of the arms with some tension in the muscles of the back and shoulder blades. Diaphragmatic breathing is performed. They spread and close their legs, just do not lift them from the bed, and then bend and unbend their legs at the knees, the foot slides along the plane of the sheet. Next, the legs are bent at the knees, the feet rest on the sheet, the task is to raise the pelvis, resting on the feet and shoulder blades. Diaphragmatic breathing is performed.

It is necessary to squeeze the fingers of the hand slowly but with tension for 2 to 10 seconds. Afterwards, bend and straighten your foot for the same period of time, tense the muscles of the shoulder girdle, hips, and back. Finally, diaphragmatic breathing is performed.

Perform the exercises calmly and set aside time for pauses during which the body rests. Each exercise is performed no more than 4-6 times, and the classes themselves are carried out 2 to 3 times a day.

At the second stage, everything becomes a little more complicated, although the starting position remains the same. You need to spread your arms to the sides and at this moment take a breath, and then slowly lower them and exhale, do this 3-4 times. Afterwards, you need to slowly, but with tension, bend your arms at the elbows, and bring your hands to your shoulders, and so on from 4 to 6 times. In the interval after the exercise, flexion and extension of the feet are performed 6-8 times.

Afterwards, you need to move your arms to the side and at the same time turn your head there. Hands rise, and inhale, and when lowering, exhale, repeat 4 to 6 times. The leg bends at the knee, stretches up and slowly lowers, and so on 4 to 5 times, and then abducts the straight leg. Straight arms are spread to the sides at shoulder level and slightly pulled back. The task is to make circular movements with your arms while simultaneously tensing your back muscles, and so on 6 to 8 times.

The arms are bent at the elbows, which rest on the surface of the bed; the task is to bend in the thoracic region, leaning on the elbows and shoulders, and so on 4 to 5 times. Afterwards, the hands are placed on the thighs and riding a bicycle is simulated, only the legs move alternately. The exercise is repeated 6 to 8 times. It all ends with diaphragmatic breathing.

The thigh muscles are tensed for 5-7 seconds, and the fingers are clenched and unclenched 8-12 times. The straight leg is raised to a level of 45 degrees, which must be held for 5-7 seconds, and then lowered, and so on 4 to 5 times. It all ends with diaphragmatic breathing. In the end, they tense the lower leg muscles for 5-7 seconds, and then raise their arms up, but only from the sides, exhale, returning to the starting position, and so on 4 to 5 times.

The starting position changes, now you will have to roll over onto your stomach, and bend your arms at the elbows and place them freely on the plane of the bed. The goal is to bend your torso 6 to 8 times. And then the head and shoulders are raised the same number of times, the straight leg is alternately pulled back, and the back muscles are tensed. At the end, passive rest is necessary.

The third period also has its own specific characteristics, the starting position on the back with the arms located along the body. The task is to spread your arms to the sides and inhale, and when you return them back, exhale, and so on from 6 to 8 times. Afterwards, slowly but with tension, the arms are bent at the elbows, and the hands are brought to the shoulders 6 to 8 times. Afterwards, it is possible to use a weight of 2-4 kilograms.

The leg is bent at the knee joint, stretched up and down 6 to 8 times, after which the exercises can be performed with weights, which can be a rubber band.

The arms are bent at the elbows, which rest on the bed; the task is to bend in the thoracic region, leaning on the elbows and shoulders 6 to 8 times. At this moment the instructor resists. After that, simultaneously, two straightened legs are raised at an angle of 45 degrees from 6 to 8 times, at the end diaphragmatic breathing is performed.

After the starting position changes and the person turns over onto his stomach, the task is to raise his head and shoulders 6 to 8 times. At this time, the instructor resists. And then, alternately, the same number of times, the straight leg is pulled back, providing resistance. It is also necessary to move your arms straight back and simultaneously raise your head, shoulders and straight legs. The goal is to hold for 2 to 3 minutes and perform 2 to 3 times.

The starting position changes, you need to get on all fours, during the first lessons the instructor must support the torso from below, in this position you should walk back and forth, and then to the right and left. Then the straight leg is pulled back, and the head simultaneously turns in the opposite direction and so on from 6 to 8 times.

The starting position changes again, and now you need to kneel down and lean on the headboard with your hands, tilting your torso a little back. Light bends are made to the sides, forward and backward with the head thrown back, and so on from 6 to 8 times each movement. It is worth moving forward and backward on your knees. And then the leg, bent at the knee joint, is moved to the side, and the head in the opposite direction, exhale, returning to the starting position, you can inhale, and so on from 6 to 8 times.

The duration of the lesson should not exceed half an hour, and the complex itself is performed 1 or 2 times a day. The duration of muscle contraction is from 5 to 20 seconds.

Exercises may involve stress

The fourth period also has its own characteristics, the starting position is lying on your back, and your arms are located parallel to your body. We start with diaphragmatic breathing, and then slowly bend our arms at the elbow joints and bring our hands to our shoulders, performing from 8 to 10 times and with a weight of 2 to 4 kilograms. The straight leg is abducted and adducted the same number of times, only a weight in the form of a rubber band is used.

Next, you need to bend your knees and rest your feet on the bed, 8 to 10 times you need to raise your pelvis, leaning on your shoulder blades and feet, at which time the instructor provides resistance. At the same time, you need to raise both legs to 45 degrees the same number of times.

Afterwards, you should lie on your stomach and in this position raise your head and shoulders 8-10 times with resistance provided by the instructor. The same number of times it is necessary to withdraw the straight leg, resistance is also applied. It is necessary to move your straight arms back, raise your head with your shoulders and legs, hold in this position for 2-3 minutes and repeat 4 to 5 times.

The starting position changes and now you need to stand up, leaning on the headboard. Rolls from heel to toe are performed 8 to 10 times, and then each leg is alternately bent at an angle of 90 degrees at the knee and hip joint, and circular movements are performed in the ankle joint. The straight leg is moved to the side and at the same time the head is turned in the opposite direction, and so on from 8 to 10 times. Additionally, you will need resistance in the form of a rubber band.

The same number of times you need to move your straight leg back using resistance, and perform slight tilts of the body backwards with your head thrown back. Half squats on toes with a straight back are performed 8 to 10 times. After that you can add a weight of 4, then 6, and then 8 kg.

Finally, the muscles of the thigh, buttocks, and back are tensed for 20-30 seconds and passive rest occurs.

The duration of the gymnastics is approximately 40 to 45 minutes and is performed 1-2 times a day.

Contraindications to exercise therapy

There are also limitations that should be taken into account before proceeding with the procedures. This:

• Serious human condition.
• The presence of persistent pain that appears after performing exercises.
• Temperature rise above 37.5.
• High or low blood pressure.
• Progression of neurological symptoms, impairment of motor activity and sensitivity.
• Asthenia after exercise.
• The presence of persistent and intractable intestinal paresis.

What are the risks of a fracture?

Each fracture leaves behind consequences; they can be expressed significantly or not, depending on the timeliness and competence of the treatment.

A fracture may result in instability, which may cause pain or disruption of the spinal axis. Often, instability compresses the spinal roots, leading to disruption of their function. Due to the deformation of the vertebra, a hump may occur, and there is a possibility that constant back pain will begin to bother you.

A compression fracture, especially of the thoracic vertebrae, is not such a simple injury. And to overcome it, the desire of the person himself is necessary. Following all the doctor’s recommendations and making a timely diagnosis will yield positive results and allow you to return to an active life. The main thing is not to self-medicate and not wait for everything to pass, and especially to avoid “traditional healers” and chiropractors, who will only do harm with their actions.

is a serious injury that can happen to anyone.

The human musculoskeletal system can often be subjected to heavy loads, some of which can result in injury. The most severe and serious injuries are those that lead to a fracture of the spine. Breaking this skeleton garment is not so easy, and this will require significant energy, which can be provided by:

• Road traffic accident.
• Work injury.
• Rope injury (fall from a height), especially to the head, legs or buttocks.
• Jumping into a body of water in an unfamiliar place.
• Whiplash injury. For example, when a car suddenly stops, the torso is fixed with a seat belt, the head inertly moves forward, the neck bends sharply, and the cervical vertebrae break. It is not the head that may move, but the entire body, and then the thoracic or lumbar vertebrae may break.
• The cause could also be a direct blow.

In order to better understand the topic, it is worth considering the anatomical structure of the spinal column.

• It consists of individual bones, which are called vertebrae. The spinal cord runs through them, which can also often be injured. The body has 7 cervical, 12 thoracic, 5 lumbar, 5 sacral (they fuse into a single monolith - the sacrum), as well as up to 5 coccygeal vertebrae.
• Each vertebra has a body, arches and processes, only the first and second vertebrae differ in their structure. The first does not have a body or processes, but only two arches that are connected to each other, and the skull is attached to it. The second has a body, processes and a tooth (the body of the first vertebra), on which the head rotates.
• The vertebrae are connected to each other by joints and intervertebral discs

Together they form curves called lordosis (forward bend) and kyphosis (backward bend).

When a fracture occurs, not one, but several vertebrae can be damaged, and fractures can also occur in different parts.

The spinal cord is often damaged. There may also be dislocations of the vertebrae, ruptures of the discs, ligaments that hold them in place, and damage to the roots. The cause of compression can be a hematoma (collection of blood) that forms after an injury.

Thus, in practice, two main groups of fractures are distinguished - with or without a complication (damage to the spinal cord).

The most common fracture is a compression fracture of the spine. It occurs from sudden compression of the vertebral body, especially in older people, and can be accompanied by spinal cord injuries.

Classification of vertebral fractures.

All spinal fractures are divided into vertebral fractures without damage to the spinal cord and with damage to it - spinal cord injury. Also, spinal fractures can be combined with damage to the intervertebral discs and nerve roots.

There are isolated spinal fractures, in which one vertebra is damaged, and multiple fractures, in which two or more vertebrae are fractured. With multiple fractures, damage to adjacent vertebrae or vertebrae located at different levels of the spine is possible.

There are stable and unstable spinal fractures. With unstable fractures, simultaneous damage to the anterior and posterior parts of the vertebra is observed, as a result of which displacement of the spine becomes possible. With a stable fracture, either the posterior or anterior parts of the vertebra are affected, so the spinal column maintains its stability.

According to domestic traumatology, compression fractures are more often observed, in which the height of the vertebral body decreases as a result of compression. Comminuted vertebral fractures are less common. Fractures of the vertebrae also occur with damage to the bodies, arches and processes - articular, transverse and spinous.

Symptoms of a spinal fracture.

Any spinal fracture and its symptoms directly depend on its location. It is known that the human spinal column includes the following sections:

• Cervical – 7 vertebrae;
• Thoracic – 12 vertebrae;
• Lumbar – 5 vertebrae;
• Sacral - 5 vertebrae fused into a single bone;
• Coccygeal - a rudiment of the tail, from 3 to 5 vertebrae.

The vast majority of fractures occur in the lower thoracic (11-12 thoracic vertebrae) and upper lumbar (1 lumbar vertebra) regions. The main signs of an uncomplicated spinal fracture, like many types of injuries, will be standard and include:

• Sharp pain that gets worse with movement;
• Visible deformation of the spinal column;
• Swelling of soft tissues;
• Skin damage - wounds, abrasions;
• Bleeding (rarely observed).

But this is not the main severity of spinal injuries. In this case, vertebral fractures are often combined with spinal cord damage. After all, it is known that the spinal cord runs through the entire cervical and thoracic spine, and ends at the level of the 1st lumbar vertebra, and below there are numerous fibers of the spinal nerves - the so-called cauda equina.

It is important to remember and understand that a spinal fracture itself is very serious and can bring with it many unpleasant and sometimes terrible consequences in the human body. It is no secret that our spine is connected with all vital organs and the functions they perform. Unfortunately, the consequences can even be disastrous, since the spine is primarily responsible for the musculoskeletal system.

If a person had a spinal fracture for one reason or another, then it is possible that he will be limited in his movements, and will also remain with an immobile part of the body, possibly for the rest of his life. This is the worst option, since a spinal fracture itself is a very serious and serious injury. If a person has such a misfortune, and he received a fracture of the spine, he needs to be patient and have good willpower. It is possible that such a patient will have to be immobile for a long time, because treatment of the spine itself can be a very long and problematic process. Of course, there are injuries that may be incompatible with life, but in such circumstances, doctors will first of all have the task of saving a person’s life.

What should you do first before identifying a fracture?

Often a bruise can be accompanied by the same symptoms as a fracture, so any spinal injury is regarded as a spinal fracture until the truth is finally established. That's why First, the person should be immobilized. Of course, a stretcher is ideal for this, but you can use a door, branches or boards, anything that is nearby and on which you can carry a person lying down, only the object must be rigid. Next, the victim is fixed by the head, torso and legs. You should not move the victim from one place to another unless absolutely necessary, nor should he move on his own. The neck should be secured with a collar. It can be factory-made or made independently from a piece of cardboard or fabric. The head should be turned to the side to prevent the tongue and vomit from entering the respiratory tract.

Remember that: If there is visible damage, it is STRICTLY PROHIBITED to straighten it!

Possible complications.

The consequences of spinal fractures can be different. They depend on the severity. Possible consequences could be:

• compression of the roots;
• spinal cord compression;
• the appearance of a hump;
• compression myopathy;
• segmental instability;
• development ;
• chronic pain syndrome;
• breathing problems;
• development of spondylosis;
• callus formation;
• formation of hernias;
• vertebral nonfusion;
• lateral curvature of the spine.

With the development of paralysis and paresis, the formation of thrombosis or congestive pneumonia is possible.

Treatment of a spinal fracture.

In the absence of complications, they begin with conservative treatment. It involves the use of painkillers, which are very good to use with, wearing a collar or corset, strict bed rest, limiting physical activity, using antibiotics, vitamins and minerals. Painkillers used include Ketorolac, Ibuprofen, and Nimesulide.

Spinal traction is used less and less today. If the thoracic region is damaged, the patient must wear a corset. Bed rest is required for one or several months. The patient must sleep on special orthopedic mattresses. After this period, the victim must wear special orthopedic devices (corset or collar).

Conservative treatment may include (phonophoresis, magnetic therapy). If the coccyx is fractured, enemas may be prescribed. Antibacterial agents should only be used in cases of infection. To eliminate pain, anesthetics are often used or performed. Rehabilitation after a spinal fracture is of no small importance. It involves gymnastic exercises (physical therapy).

This is the final stage of therapy. It must be remembered that conservative treatment is only justified for uncomplicated fractures without vertebral displacement.

Be careful, remember that the spine is the foundation of your entire body. Do not expose your life to danger, avoid unjustified risky actions (unless of course this is your professional duty). Be healthy!

The musculoskeletal system in childhood is not strong enough, since the bones are actively growing. Because of this, various injuries in children occur much more often than in adults, however, due to the high compensatory capabilities, fractures heal much faster, of course, if the necessary assistance is provided correctly and in a timely manner. For example, in case of compression injury to the spine, a whole range of measures is carried out, which includes physiotherapeutic procedures, massage, physical therapy, wearing a support corset, and in some situations surgical intervention is indicated.

What is a vertebral compression fracture?

The spine, which is the main section of the musculoskeletal system, consists of vertebrae - small-sized bone rings that have a body, an arch and form the spinal canal containing the spinal cord.

A compression fracture, violating the integrity of the spinal column, primarily affects the vertebrae. Compression means a strong and/or sharp compression, squeezing of the spine, as a result of which the anterior part of the vertebra (or several bone rings) acquires a wedge-shaped shape. In some cases, the vertebra is so deformed that its fragments are embedded in the spinal canal, compressing or damaging the spinal cord.

According to statistics, in childhood the following parts of the spinal column “suffer” due to anatomical features:

• cervical - in 1.5% of cases;
• upper thoracic - 5.8%;
• medium chest - 61.7%;
• lower thoracic - 21.5%;
• lumbar - 9.5%.

The rarest and most dangerous in terms of undesirable consequences is considered to be compression injury to the spinal column in the cervical region. It is fraught with paralysis of the respiratory muscles, and if the spinal cord is injured, the child faces almost complete immobility.

Classification

When classifying compression injuries of the spinal column, several parameters are taken into account:

• the degree of compression (deformation) of the vertebral body as a result of mechanical action;
• features of damage;
• severity of symptoms.

Experts distinguish 3 degrees of vertebral deformity due to a compression fracture:

1. Mild - the vertebra is reduced by no more than 30% of its original size.
2. Moderate - there is almost 50% compression of the vertebra.
3. Severe - characterized by a sharp decrease in the height of the vertebral body - by more than 50%.

When studying the characteristics of the injury, doctors divide compression fractures into the following types:

1. Wedge-shaped. The anterosuperior part of the vertebral body (facing the sternum) takes on a wedge-shaped shape.
2. Compression-tear. This type of injury is a variant of the previous type of fracture. As a result of the injury, the anterosuperior part of the vertebra is torn off; the x-ray shows a rupture line with uneven contours. This fragment moves forward and slightly downward, damaging the ligaments.
3. Fragmentation. With such damage, the vertebral body and even the intervertebral discs are divided into several parts. Splinters from the posterior vertebrae often penetrate the spinal canal, damaging the spinal cord.

Based on the severity of symptoms, compression injuries of the spine are divided into two types:

1. Uncomplicated. The child feels short-term pain of moderate intensity immediately after the fracture. This type of injury often occurs in a hidden form, since parents mistake the serious injury for an ordinary bruise.
2. Complicated. Such a fracture is very easy to notice, since in addition to pain, neurological symptoms are observed. Vertebral fragments damage the spinal cord or nerve roots, which is manifested, for example, by loss of sensation.

Doctor about vertebral compression injury - video

Causes of compression fracture

The main cause of compression injuries of the spine in children is strong mechanical impact. Most often, a fracture occurs if the child:

• falls from a height onto the back or chest, legs or buttocks;
• sharply bends the back during somersaults;
• receives a strong blow to the spinal column;
• hits his head while diving (so-called diver's injuries - the main cause of compression of the cervical spinal column).

Among the factors that provoke the occurrence of compression fractures in children, experts identify the following prerequisites:

1. A healthy spinal column can withstand quite high physical loads. In the case of a weak or underdeveloped spine, even light loads lead to compression injuries.
2. With osteoporosis, which also occurs in children, bone density decreases, resulting in an increased risk of compression injuries even during normal activities: jogging, walking, squats.
3. Due to a lack of vitamins and certain minerals (especially calcium), the condition of the entire body, including bone tissue and muscles, deteriorates. This is why the spine becomes weak and cannot always withstand physical activity.

Quite often, compression injuries are combined with other injuries, for example, fractures of the arms and legs, pelvic ring, and concussion. And the “blame” for this is children’s mobility, since a child can fall while playing, in physical education class, and during any other activity.

Symptoms and signs

The symptomatic picture of spinal compression is not always pronounced, especially if the fracture is uncomplicated. The main symptoms of spinal injury are pain of varying degrees of intensity and limited movement. The severity of these signs depends on the location of the fracture:

1. If the thoracic region is damaged, the pain is localized in the interscapular region, but is usually of a girdling nature. After an injury, the pain is strong, and breathing is held for 3–5 minutes. In this case, the skin becomes pale and bluish. After respiratory function is restored, the painful sensations weaken and become less localized.
2. If the lumbar region is injured, breathing is maintained, but the child experiences severe pain in the abdominal area, especially when turning from back to stomach. In some situations, there is increased tone of the spinal muscles and curvature of the spine at the site of injury.
3. If a child has injured the cervical spine, the pain causes particular inconvenience when moving the head and when pressing on the damaged area.

More rare symptoms of compression fractures (in case of complicated trauma) in a child are:

• problems with urination;
• defecation disorder;
• partial paralysis of the limbs;
• lowering blood pressure.

Sometimes, after an injury, a child is unable to get up and walk, so he is taken to the doctor in a supine position. Usually, with mild compression fractures, children move independently and relatively normally.

This is why some children go to the doctor very late, when their condition worsens significantly. This is why any back injury requires immediate medical attention, as internal organs may also be damaged.

Diagnostics

Diagnosis of all types of fractures is carried out by a traumatologist who studies the circumstances of the injury, the clinical picture and examination data.

First of all, the doctor palpates the spine to determine the most painful place, indicating the damaged area. In the case of severe compression, which is accompanied by displacement of the arches, pathological kyphosis is observed - an increase in the physiological curvature of the spine.

It should be understood that examination does not always provide an accurate picture of a violation of the integrity of the vertebrae. Therefore, traumatologists often prescribe a whole range of instrumental diagnostic methods:

1. X-ray of the spinal column is the main research procedure to detect the presence of a fracture. X-rays are performed in lateral and direct projections in order to accurately determine the location of the injury and its degree.
2. Magnetic resonance imaging (MRI) is an additional diagnostic method that is prescribed to confirm or refute suspicions of injury to nerve endings.
3. Computed tomography (CT) is used to examine the damaged area in more detail to identify changes in bone structure. It is also necessary if a bruise has formed at the fracture site - a CT scan will help detect internal hemorrhages.
4. Densitometry is an X-ray examination of bone mineral density, which is indicated if osteoporosis is suspected in a child.

It is important to differentiate a compression fracture from juvenile kyphosis (stooping), congenital wedge-shaped vertebrae and other anomalies. In addition, to determine the presence of associated injuries, the doctor may refer the child to specialists in neurosurgery and neurology.

Treatment of a child

With mild compression injuries of the vertebrae, there are often cases when the child is taken to the hospital by the parents, since the symptoms are mild, and the children remain mobile, complaining only of pain in the shoulder blades.

Doctors recommend immediately calling an ambulance for any spinal injury in children. If the child does not move, it is strictly forbidden to tug, shake or try to turn him over onto his stomach. Parents need to calm down the injured child and talk with him until the medical team arrives.

The child must be transported in the position he took after the fracture, having first laid him on a hard surface. This will reduce the risk of damage to the spinal canal by vertebral fragments if they were formed due to injury.

A child who has suffered an uncomplicated compression injury is treated in a hospital and then undergoes recovery on an outpatient basis under the supervision of a surgeon or traumatologist. In the case of complicated spinal injury, the duration of therapy is determined individually, and rehabilitation takes place in special centers.

“Classical” treatment of a compression fracture in a child consists of the following steps:

1. The doctor relieves pain using medication (taking into account the patient’s age). In particularly severe cases, opioid analgesics are prescribed.
2. Based on the diagnostic results, the attending physician determines the severity of the fracture and chooses a conservative or surgical method of treatment.
3. Then rehabilitation measures are carried out, which are aimed at restoring muscle tone and the function of flexion and extension of the spinal column.

Conservative therapy

Mild compression fractures are usually treated conservatively. To restore damaged vertebrae, a corset is put on the affected area. In addition, the following methods of therapy are indicated:

1. Functional. If the vertebral body is compressed by a third, and there is no neurological damage, the doctor prescribes correction of the spinal column for the child using longitudinal traction on an inclined board.
2. Reposition. This method involves a consistent increase in the angle of inclination of a rigid surface (for example, an orthopedic bed). The procedure allows you to gradually improve the degree of extension of the spinal column.

Surgical methods

For moderate to severe compression, doctors usually prescribe surgical treatments. In childhood, low-traumatic (closed) operations under local anesthesia are indicated:

1. Vertebroplasty. During this procedure, a special hardening solution is injected into the body of the damaged vertebra. This manipulation is carried out through a small puncture in the skin using a special needle.
2. Kyphoplasty. A method that allows you to restore the shape and height of bone rings. Using a thin tube, a tiny balloon is inserted into the damaged vertebra, which lifts its body and forms a cavity in it. Then the balloon is removed, and the resulting space is filled with a hardening solution. This procedure allows you to:

   reduce pain;

   prevent further descent of the damaged vertebra;

   restore anatomically correct vertebral curves;

   reduce the likelihood of compression fractures in the future.

In particularly severe cases, open operations performed under general anesthesia are indicated. Surgeons stabilize the vertebra by connecting it to its neighbors using special fixing elements.

Rehabilitation

Proper treatment is only part of the treatment for a damaged spine. Another extremely important element for the restoration of the vertebrae is a set of rehabilitation measures. Their appointment and implementation depends on the severity of the injury, the presence of complications (for example, spinal cord injury) and the success of therapy.

Main restoration measures:

• physiotherapy (paraffin wrap, ultra-high frequency therapy, magnet treatment);
• massage (performed by a specialist, since the success of the entire course of treatment depends on the quality of the treatment);
• swimming (children are often recommended to visit the pool to restore mobility to the spine and build muscle).

The main method of recovery after a compression fracture is physical therapy exercises (PT), carried out in parallel with other activities. For mild damage to the vertebrae, exercise therapy is prescribed from the very first days after the injury.

Physical therapy, like therapy, is divided into several stages, and the first three should be carried out in a supine position:

1. In the first 7 days after compression injury, simple exercises are performed, the purpose of which is to improve the functioning of the gastrointestinal tract, heart and respiratory system, and also prevent muscle atrophy. For example, the child is shown:

   flexion and extension of the hands, elbows and feet;

   squeezing and unclenching of hands;

   bending the legs at the knees;

   deep diaphragmatic breathing.

2. Exercises in the second stage (the next 2-3 weeks) are aimed at improving blood circulation, forming and strengthening the muscle corset. The child is allowed to perform exercise therapy while lying on his stomach. Under the guidance of an instructor, the child:

   moves his arms in different directions, raises them;

   bends the legs at the knees and straightens them with lifting;

   performs a “bicycle”;

   raises head and shoulders.

3. At the third stage, which lasts about a month, the child’s spine is prepared for a vertical position through strengthening the pelvic and spinal muscles. Features of the exercises:

   performed using a rubber band;

   children stand on all fours.

4. The last stage of exercise therapy is characterized by an important event: the child gets out of bed. Therefore, it is important to ensure that the spinal column gets used to the vertical orientation and restore general motor activity. Children perform exercises leaning on a bed or wall:

   lift and abduct the legs;

   bend over;

   roll from heel to toe.

Even after the end of the rehabilitation period, the child is observed for several years. All this time, therapeutic exercises are performed under the supervision of specialists.

Therapeutic gymnastics at home - video

Lifestyle and nutritional habits

When treating and rehabilitating compression injuries of the spine, it is important to follow all doctor’s instructions. For example, it is necessary to monitor active children who have difficulty maintaining bed rest and limited movement.

After the child returns home, it is worth making sure that he wears a corset (if necessary), takes medications to strengthen bones, refrains from excessive physical activity, and attends therapeutic massage sessions.

In addition, parents of young patients need to adjust their diet to strengthen and restore bone tissue. To do this, the diet includes foods high in the following vitamins and minerals:

• calcium - present in large quantities in dairy products, including cheese, legumes, nuts, sesame seeds, herring and salmon fish;
• magnesium - present in nuts, salad, bananas and seafood;
• zinc - found in large quantities in cocoa powder, seafood, nuts, beef, buckwheat;
• vitamin B6 and folic acid - these elements are present in liver, legumes, beets, bananas.

During treatment and rehabilitation, it is necessary, as far as possible, to avoid foods that wash calcium from the bones (strong coffee and tea, soda) and interfere with its normal absorption (fatty foods). Cheese is a tasty and healthy “supplier” of calcium. Cottage cheese contains calcium that is easily digestible by the body.
Legumes, particularly beans, contain a lot of calcium.

Possible complications and consequences

Rehabilitation of a child after a compression fracture of the spine takes a long time and requires enormous patience from parents. The most favorable prognosis concerns mild vertebral damage, which usually results in complete recovery.

In case of delay in seeking medical help or a complicated fracture, complications such as:

• curvature of the spine - post-traumatic kyphosis and scoliosis;
• osteochondrosis (degenerative changes in the intervertebral discs, vertebrae and nearby joints);
• spinal canal stenosis;
• damage to the nerve roots, which in some situations leads to paralysis.

Of course, it is almost impossible to protect a child from various injuries and falls. However, parents can still prevent the occurrence of a compression fracture if they provide their children with proper nutrition, rich in calcium and vitamins, the required level of physical activity, and also do not forget about regular examinations of the child’s skeleton. Only in this case will the child’s spine remain strong and healthy.

Various manifestations of osteochondrosis may appear in the lumbosacral region. Today this is a fairly common phenomenon. This happens because this zone receives maximum load. The lower back supports the majority of all human weight. The load here never decreases, since even during sleep this department does not receive strong relaxation.

Because of this, massage of the lumbosacral region is very useful, it is worth doing even for the purpose of prevention.

Most often, pain is caused by a hernia between the vertebrae. It is a manifestation of osteochondrosis, due to which one disc between the vertebrae loses its shock-absorbing function, and neighboring discs suffer from this. If you do not begin to treat this problem, then as a result, due to a chain reaction, the disks may begin to fail one after another.

News line ✆

Spinal massage is a very useful procedure that can help get rid of many diseases. It is capable of performing the following functions:

• relieve pain not only in the muscles, but also in the joints and areas around them;
• normalize the functions of the spine, a person will be able to lie down, sit down, etc.;
• expand the capabilities of the upper half of the body and many other positive functions.

Massage of the lumbosacral region

When any violations of the spinal discs occur, which are the initial stage of the further appearance of a hernia, massage is necessary. It will act as a preventive measure. With its help, the cartilage will not degenerate, the ligaments will be in normal condition, not stretched. In addition, massage will not allow bones to grow and joints to take an unnatural position.

When diseases of the lumbosacral region appear, and injuries also occur, the following procedures are performed at home 3 times:

• stroke this section with both hands, the movements should be massage, directed from the broad muscles to the buttocks, and then back, while massaging should be done clockwise;
• rub the fingertips, which are at right angles to the body, in a circular motion near the spine, after which stroking is performed;
• such movements should be performed with the edge of the palm, starting from the sides, ending with the bottom of the buttock;
• you should squeeze with the edge of your palm, and then knead;
• devote time to the buttocks, which are stroked, squeezed and kneaded with the palm of your hand or fingers;
• The buttocks should also be shaken, and attention should also be paid to the tailbone.

If you do a massage, the hardened muscles will disappear; in addition, this procedure will relieve local rigidity, as well as pain, swelling, and compactions that appear in the muscles. This will be especially useful for diseases of the spine.

When a person just starts doing massage, he should be careful, not to put a lot of effort, so as not to cause pain. Subsequently, you need to intensify the movements a little.

Techniques used in massage

The area that needs to be massaged is quite large. This should be taken into account, so it is better to start kneading the gluteal muscles first. Only after this is it recommended to start massaging those areas that are especially affected.

First, the pelvic area is stroked, after which you can begin to squeeze and knead. This stage allows you to warm up the muscles; it needs to be completed with stroking again.

After this, the muscles will be ready for further, more powerful procedures. You can start kneading with the ridges of your fists, but you should complete such actions with stroking again, as this can calm the muscles so they don’t get stressed.

Rubbing during a massage can be of different types:

• fingers, you can use pads or knuckles;
• palms.

If a person does not have massage experience, then he needs to be careful, especially with intense effects. After all, it is very easy to harm a patient. Because of this, it is best to contact a specialist who knows the secrets of massage, which will not aggravate the situation, but, on the contrary, will improve the condition.

Of course, there are situations when there is no time or opportunity to visit a massage therapist. In this case, you can do this procedure yourself, but you must familiarize yourself with the implementation method. Although this will not make a person an excellent specialist. The best solution would still be to see a doctor.

Massage for compression fracture of the spine

Benign tumor

When a person develops a benign tumor of any part of the spine, massage is considered a prohibited procedure. In this case, there are other treatment methods. If you still massage, the tumor may begin to grow. In addition, heating has a negative effect on it. All these procedures can also lead to a spinal fracture.

Basic massage methods for spinal fractures

When a spinal fracture occurs, massage can be started from the second day after traction is recommended to the patient. Massage can reduce reflex excitability, improve the elasticity of joints, and prevent them from deforming.

If a person has injuries to the lumbosacral region, the specialist selects a massage depending on how severe the fracture was, taking into account the number of vertebrae that were damaged. Massage techniques should be strictly controlled so that spastic muscles do not become overexcited and pain does not appear.

Therapeutic massage for fracture

There is therapeutic abdominal massage. It is carried out to strengthen the muscles, and the blood will not stagnate. Although the spine has been fractured, we must not forget about the hips, which should be stroked and kneaded with circular movements.

By the way, you also need to massage your shins and hands. This has a positive effect on joints and muscles.

During the treatment period after a fracture, the patient wears a corset with which he walks, sits and stands. Because of this, the massage technique becomes more complicated, and the duration of the procedure increases. The patient lies on his stomach, and the specialist performs the following procedures:

• first he strokes it, then squeezes it;
• where the long muscles are located, kneads with the palm, thumb or phalanges of the fingers;
• Massages the broad muscles with double circular movements;
• rubs between the ribs, and also pays attention to the shoulder blades.

After this, the patient lies on his back, after which his thoracic region is massaged, as this has a positive effect on the condition of the spine.

Although the fracture occurred in the lumbosacral area, after removing the plaster, massage of the cervical spine should also be done.

Therapeutic massage begins with the chest. Then time is spent on the abdomen, which is stroked, and then the oblique and rectus muscles are kneaded. The main thing is not to cause pain to the patient. To ensure that the limbs are in a relaxed state during the massage, a cushion is placed under the knee.

Specialists use camphor alcohol when they massage the sacrum and buttocks in the first period. This will help prevent bedsores from occurring. In addition, tissue trophism will not be disturbed.

When the second period of rehabilitation after a fracture begins, the patient can already walk normally. In this case, he is advised to strengthen his back muscles, but he should not forget about his legs. Massage and gymnastics will help formulate correct posture and restore strength after injury.

When a massage is performed after a fracture, the doctor must take into account the presence of spinal diseases, if any.

Contraindications for massage

There are also contraindications that should be taken into account before starting lumbosacral massage. This:

• bleeding, blood diseases;
• when purulent processes are observed;
• if you have skin diseases;
• presence of rashes, irritations;
• the appearance of fungus, cracks, gangrene;
• the development of inflammation, which is accompanied by high temperature and fever;
• swelling;
• various injuries;
• acute venereal diseases;
• severe allergies that manifest themselves on the skin;
• vomiting or nausea;
• painful sensations when touching the stomach with fingers, etc.

Massage of pain points of the lumbosacral region for radiculitis

It is best to massage pain points when a roller is placed under the abdominal area. Under no circumstances should you use full force, as this may aggravate the condition.

Massage should be started when the person is still on bed rest.

All movements will be aimed at relaxing the muscles. When the patient feels severe pain, one should be especially careful. It's best to warm up your back first. To do this, you can use a heating pad or a bath using electric light. The patient must be placed on a hard surface, and he must lie in the way that is least painful for him. The massage technique includes:

1. From the very beginning, attention is paid to paraverbal points. At the same time, rub your fingers with your palm in a circular motion. A few minutes are allocated for this.
2. To make muscle hypertonicity weaker, vibration is used; there are even special devices for this.
3. After this, you can begin massaging the long spinal muscles. To do this, first they are lightly stroked and then grasped deeper. After this, rubbing is applied. Patients with radiculitis in the lumbosacral region may feel spasms, chilliness in the feet, and cold, since their sympathetic part of the nervous system is highly excited. Based on this, it is forbidden to make vigorous movements during massage.

If there is inflexion of the spine, then the muscles are stretched and weak. Therefore they need to be strengthened. Vibration, which should not be interrupted, on the side of the arc where it is concave can help with this. You can’t clap in such a situation so as not to cause harm.

Calf muscle massage

To get the best effect after a massage of the lumbosacral region, do not forget about the legs. The patient should lie on his stomach, and the doctor should perform the following procedures:

• first, with both hands he strokes the limbs from heel to thigh;
• rubs alternately;
• continues stroking, while applying more force;
• rubs the skin with four fingers;
• then the specialist grabs it with both hands and strokes it, while the movements should not be interrupted.

You need to massage the outer abdomen of the leg, and then its inner part. Movements should start from the heel. When the inner abdomen is massaged, the doctor's thumb slides along the inside of the bone, and the rest of the fingers on the inside.

Also, don’t forget about the front muscles.

Here you should perform all the same movements. You can add spiral rubbing using your thumb, or you can stroke it over the skin. In addition, forceps-like movements are made.

Some massage tricks

Massage of the lumbosacral region is carried out in the sacrum area, as well as the gluteal muscles and the entire limb. There are several techniques that massage therapists use to get good results. The patient lies on his stomach, and the specialist performs the following movements:

• places the palms on the crests of the iliac bones, and then oscillates between the edge of the ribs and the crest;
• the hand is placed on the lower back so that the thumb is placed on the sacrum, and then they make circular, screwing movements, and work through all the roots with the hand;
• make small circular movements with your fingertips, the main thing is that they fit tightly to the skin and gradually compress it;
• the muscles are worked from the axis, the crest, moving to the sacrum (the movements are circular, light, without displacement);
• The thumb and index fingers are spread apart, placed on the spine, and then movements are made to meet each other.

So, massage of the lumbosacral region requires caution, especially when the patient has injuries or illnesses. This procedure can significantly improve the condition.

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In case of spinal trauma, fractures of the vertebral bodies, arches, spinous and transverse processes are observed. Compression fractures of the vertebral bodies are common. Vertebral fractures are often accompanied by damage to the intervertebral cartilaginous discs. A rupture of the fibrous ring of the disc occurs, where the nucleus pulposus can penetrate, and a so-called disc herniation can form. This hernia compresses the roots of the spinal nerves, causing the corresponding symptoms. Severe fractures of the spine with compression or rupture of the spinal cord are accompanied by deep paresis or paralysis of the muscles of the limbs and torso, and dysfunction of the pelvic organs. When the spine is fractured, its function suffers, which is manifested in a decrease in its flexibility, mobility and loss of spring qualities; when trying to move and upon palpation, severe pain occurs at the fracture site. A hematoma forms at the fracture site and movement disturbances are observed. The main objective of treatment of compression fractures of vertebral bodies is to prevent further deformation of the damaged vertebral bodies and spinal cord from compression, correct the shape of the damaged vertebral body, unload the spine and preserve its functional ability. The treatment method for compression fractures of the vertebral bodies is determined by the location, nature and extent of damage, as well as the age and general condition of the patient. With slight compression, the spine is unloaded in young and middle-aged people. For this, the patient is placed on a bed with a wooden board. Traction, therapeutic exercises and massage are used. For fractures of the cervical and upper thoracic vertebrae, traction is performed using a Glisson loop. In case of a fracture in the lumbar or lower thoracic spine, traction is carried out using axillary straps. A Glisson loop or armpit straps are secured to the head end of the bed, which is raised to form an inclined plane. The patient is on strict bed rest. He is not allowed to stand up, sit, or turn on his side. Treatment of patients with vertebral body fractures is carried out according to periods. First period (first 15 days after injury). During this period, massage of the limbs begins from the fifth to seventh day after the fracture. The massage aims to improve blood and lymph circulation and stimulate regenerative processes. General massage is used on the limbs. On the upper limbs it consists of grasping continuous stroking, alternating rubbing, stroking, spiral rubbing with four fingers, stroking, longitudinal kneading, stroking, double circular kneading and stroking. It is enough to massage each hand for 5-7 minutes daily. On the lower extremities the following is used: grasping continuous stroking from the base of the toes to the inguinal fold, alternating rubbing, stroking, spiral rubbing with four fingers, stroking, longitudinal continuous kneading, stroking, transverse simple continuous kneading and ending with grasping continuous stroking. Seven to ten minutes daily is enough to massage each leg. When massaging the upper and lower extremities, manual vibration is not used. From the very first days, in order to prevent bedsores, the places where they may form are massaged according to the method described above. The belly is massaged only if you are prone to constipation according to the above method. Second period (from the fifteenth to the twenty-first day). The purpose of this period: further strengthening of the muscles of the limbs, shoulder and pelvic girdle, abdominal muscles and back muscles. At the end of this period, the patient is allowed to turn from his back to his stomach, provided that the straight position of the spine is maintained. During this period, the limbs continue to be massaged, but the depth of the massage effect increases compared to the first period and more emphasis is placed on kneading. After turning on the stomach, for the first two to three days a light back massage is performed, consisting of plane superficial stroking, alternating rubbing, deep stroking in three rounds, sawing, grasping stroking in two rounds, spiral rubbing with four fingers, and flat surface stroking. At the same time, the fracture area is spared. In the following days, gradually increase the force of pressure when performing massage techniques, including semicircular kneading, transverse continuous kneading, and rolling. Third period (from the twenty-first to the twenty-eighth day). The purpose of the massage is the same. During this period, they continue to gradually increase the load during the massage. As the patient becomes more active, the need for massage of the limbs and abdomen gradually disappears. Therefore, the massage therapist can spend more time massaging the back and especially the soft tissues along the spine along the paravertebral lines. Here they begin to use smoothing with the thumbs, spiral rubbing with two thumbs, smoothing, shifting, smoothing, intermittent pressure, smoothing, mechanical vibration with a spherical vibratode. Fourth period (from the twenty-eighth to the thirty-fifth day). During this period, the patient is prepared to stand up. All massage techniques are used on the back with the exception of manual intermittent vibration. The patient should get to his feet from a lying position on his stomach, without bending his back, leaning on his straightened arms. He is allowed to sit three months after the injury to avoid secondary radiculitis. When treating patients with fractures of the cervical vertebrae, neck massage is used, where special attention is paid to massage of the trapezius and sternocleidomastoid muscles. When adapting to the forced position of the patient, they use the techniques of planar and tong-like stroking, spiral rubbing with four fingers and tong-like kneading. It is more convenient to perform the techniques with one hand, in reverse. The massage therapist's free hand fixes the patient's head at this time. Neck massage not only improves muscle tone, but also enhances blood and lymph circulation, tissue nutrition, stimulates regenerative processes, reduces and eliminates pain. In cases of paresis and weakness of the muscles of the upper extremities, massage the upper extremities according to the massage technique for flaccid paralysis. The most flaccid muscles are massaged selectively, using mainly forceps-like kneading and mechanical vibration with an ebonite hemispherical vibratode. When applying a plaster semi-corset with a collar, after removing it, massage the neck and shoulder girdle. On the front surface of the neck, with the patient in the initial sitting position, general stroking is applied with both hands from the chin to the angle of the lower jaw, then along the sternocleidomastoid muscle to the manubrium of the sternum and above the collarbones to the sides to the shoulder joints. In the same direction, spiral rubbing is performed with four fingers simultaneously with both hands and separate stroking alternately with the left and right hands. Continuing to stand behind the patient, the massage therapist massages the sternocleidomastoid muscles on both sides simultaneously. His hands move from top to bottom along the sternocleidomastoid muscles from the top of the mastoid process to the sternum and collarbone in an anterior motion. At this time, his fingers are facing the end phalanges towards the sternum. On the sternocleidomastoid muscle, planar stroking is used with the pads of the second, third and fourth fingers. This is followed by spiral rubbing with three fingers, pincer-shaped stroking with the pads of the thumb and forefinger, pincer-shaped kneading with the same fingers and planar stroking. Then they move on to massage the back of the neck and shoulder girdle, where they apply: 1. Embracing stroking. 2. Alternate rubbing. 3. Plane stroking from the base of the occipital bone to the shoulder joints in reverse. 4. Sawing. 5. Plane stroking in reverse. 6. Spiral rubbing with four fingers in reverse. 7. Plane stroking in reverse. 8. Spiral rubbing of the soft tissues with the thumb along the paravertebral lines between the spinous and transverse processes of the cervical vertebrae. 9. Stroking. 10. Forceps kneading. 11. Embracing stroking. Massage of the front and back surfaces of the neck and shoulders lasts 15 minutes daily. The massage course consists of fifteen procedures. The massage begins the next day after the corset is removed. In case of a fracture of the transverse and spinous processes, the spine is unloaded on a bed with a shield for two to three weeks. Massage is prescribed from the second or third day after the injury; the back and soft tissues along the spine are massaged. massage improves the functional state of muscles, relieves pain and reflex muscle tension, accelerates the regeneration process. Massage procedures are performed daily for 15-20 minutes throughout inpatient treatment, and, if necessary, continue on an outpatient basis. Treatment of patients with spinal fractures complicated by damage to the spinal cord In the case of mild compression of the spinal cord and its roots, an unstable disturbance of sensitivity and a decrease in the functional ability of the muscles are observed. In this case, selective massage of muscles and muscle groups is used. Severe damage to the spinal cord leads to the development of flaccid or spastic paresis or paralysis. For paresis and paralysis, the appropriate massage technique is used.