Spine Fracture

Our backbone consists of 33 spinal bones. Spinal fractures can occur in any of these bones. But; 64% of vertebral fractures occur in our spine bones in the waist and back region. Spinal fractures are most common in the T12 and L1 vertebrae bones. Traffic accidents, motorcycle accidents, falls from heights, gunshot injuries, sports accidents, osteoporosis can cause such fractures.

Osteoporosis is of great importance in such fractures. Especially in elderly patients, osteoporosis causes fractures due to the deterioration of the spongiosa in the spinal bones and loss of support. In cancers that involve the spine, a tumor located in the spine may disrupt the bone structure and cause a fracture. A fracture in the spinal bone can disrupt the patient's posture and cause pain.

Spinal Fracture Symptoms

Symptoms may vary depending on the damage and pressure on the spinal cord and nerves in the affected area. Symptoms of a spinal fracture are listed below according to their severity.

• Sudden back or back pain

• Loss of strength (paralysis)

• Numbness, tingling

• Numbness

• Neurogenic shock

• Spinal shock

Types of Spinal Fractures

Compression Fractures - Burst Fractures (Burst Fractures)

The most common type of spinal fracture is collapse fractures . In this type of fracture, collapse occurs in the anterior region of the spine. As a result of collapse, wedging occurs in the spine.

In burst-type fractures ( burst fracture) , fragmented fractures occur in the spine. These fractures can progress towards the spinal canal, causing damage to the spinal cord and nerves.

Fracture-dislocations

It occurs in more serious traumas. The connection between the spinal bones is severed. There will be breaks in the bonds and tears in the disc. Spinal cord injury is often present in this type of fracture. It is usually treated surgically.

Spine Fracture Diagnosis

A patient suspected of having a spine injury should be brought to the hospital as soon as possible. It is very important that the first response is made by conscious and trained personnel during the accident and during the transportation. Improper patient handling can make even a minor injury serious.

X-ray: It is the first examination to be performed on patients. The diagnosis of spinal fractures can be made simply with this examination.

Computed tomography : It is a frequently used test in traumas due to its sensitivity to bone. The diagnosis of spinal fractures is made with this examination.

Magnetic Resonance Imaging (MRI): Imaging of soft tissues, ligaments, nerves and spinal cord is performed. Damages in the spinal cord can be viewed radiologically.

Spine Fracture Treatment

Conservative or surgical treatment is applied according to the treatment of spinal injuries, the type of injury and whether there is spinal cord damage. Purpose in treatment; restoration of the spine and returning patients to their previous activities in a short time without pain. Only patients with collapse in the anterior part of the spine and whose ligaments connecting the bones are not affected by injury can be treated conservatively with bed rest and a corset. A 3-month corset or orthosis may be recommended.

Kyphoplasty or vertebroplasty (bone cement treatment) methods injected into the bone within 2 months after the spine fracture can be applied in compression fractures. Kyphoplasty and vertebroplasty are methods used in the treatment of spinal fractures. In vertebroplasty, cement is injected into the spine. This cementum freezes inside. In kyphoplasty a balloon-like device is inflated inside the spine. After creating an area in the bone, cementum is injected. It causes an increase in the height of the collapsed bone a little higher. These are methods that can be easily applied with local or general anesthesia according to the surgeon's preference.

Based on my experience with vertebroplasty and kyphoplasty in compression fractures, I think it is very successful in reducing pain and patient comfort for patients.

What are the Risks of Kyphoplasty and Vertebroplasty Treatment:

• Infection

• Bleeding

• Increase in low back pain

• Nerve damage

• Allergic reaction

• Cementum leaking out of the area to be applied

Apart from these methods, another treatment applied in spinal fractures is fixation of the spine with titanium implants. These surgeries, which are performed under general anesthesia, are often performed with posterior approaches. It is the fixation of the vertebrae by placing screws on the spine in the transpedicular way and connecting the screws to each other with connection apparatus called rods. Bone pressure on the spinal cord and nerve can be removed during surgery with decompressive surgery.

Dr. Tamer Tekin