Spinal Compression Fracture

The lack of proper treatment for spinal compression fracture can lead to serious complications. In Germany, therapy is provided with the involvement of sophisticated endoscopic methods, such as vertebroplasty and kyphoplasty, which are hardly used in Russia.

The compression fracture (CF) results in the vertebra compression in height. Such damage is one of the most common spinal injuries.

CF occurs in osteoporosis characterized by a weakening of the bone tissue of the vertebrae, which makes them unable to withstand even a normal load. As a result, the damage can develop due to coughing, bending the back, lifting objects. Also, CF may be the result of an unsuccessful fall or a blow, in which the spine experiences multiple overloads.

Pathogenesis

The human spinal column consists of 33 vertebrae and performs a supporting function, imparts mobility and protects the spinal cord. The cylindrical part of the vertebra is called the body. It is the location of the damage related to the compression fracture. In osteoporosis, CF usually occurs in the thoracic spine, whereas the spinal cord injury is extremely rare.

More severe injuries that are a consequence of car accidents or other injuries result in the impaired spinal canal geometry and pressure exerted on the nerve structures of the spinal cord due to the CF. Such exposure leads to severe neurologic symptoms, including total paralysis of organs controlled by the spinal cord regions below the fracture site.

Etiology

CF occurs when the vertical load on the vertebra exceeds the limit value: either due to degenerative changes in bone tissues or due to the excessive traumatic load. In the first case, the fracture often occurs in the anterior part of the vertebra, in the second case it affects the posterior one.

Osteoporosis is the most common cause of CF. In this disease, the bones can be so weakened such that a simple slope results in a fracture. The compression of the anterior part of the vertebra changes the geometry of the spine, which lead to the development of a hump - kyphosis.

Parathyroid disorders can also result in fragile bones. This gland produces a hormone that controls the levels of calcium in the blood. With increased secretion, calcium is leached from the bones, which leads to further weakening.

The metastases of malignancies spreading on the spine from other organs also cause weakening of the vertebrae and lead to the fracture.

A traumatic injury is the cause of the most severe forms of the compression fracture. It often occurs when the spine is bent forward, while the posterior part of the vertebra, which is dangerous for the spinal cord, is damaged.

Symptoms

The compression fracture in osteoporosis or other diseases that weaken the vertebrae almost does not cause any pain. The external manifestation of the CF is the development of a hump. The reduction of the height of the spinal column shortens the back muscles, which in this case work more intensively, which leads to muscle fatigue and pain. Pain usually subsides by the end of the second week, but in some cases it may be acute.

Traumatic CF is much more painful: severe pain occurs in the back and radiates to the legs. Should bone fragments get into the spinal canal due to the fracture, a person will develop paralysis or loss of sensitivity. Also, the person develops destabilization of the spine, which ultimately leads to kyphosis and increases the risk of spinal cord injury.

Diagnostics

Having studied the symptoms and the medical history, doctor performs an X-ray, in which one can clearly see the compression fracture. Radiography is sufficient to confirm the diagnosis, but to assess concomitant lesions one may need more accurate examinations:

• CT can detect spinal instability. Should spinal cord injury be suspected, it is necessary to conduct myelography, which is contrast-enhanced computed tomography.
• MRI is an alternative to CT and myelography.
• Osteoscintigraphy is performed to study bone tissues, determine the presence and extent of degenerative changes.

Treatment and rehabilitation

The bone tissue of the damaged vertebra is gradually healed (if the load is minimized, this takes about 2 months). However, the absence of surgical intervention inevitably leads to the deformation of the vertebra, which is reflected in the arch of the spine. A severe bend can lead to many complications in the future. Therefore, in case of a severe deformation we recommend corrective surgical procedures, which can be performed in the Medical Travel Center with the use of modern endoscopic techniques. Learn more about the treatment of compression fracture in Germany..

If the traumatic CF affects the spinal cord, in addition to surgical treatment (in this case extensive surgical intervention may be required), the spinal injury should be followed by rehabilitation: without the professional rehabilitation the patient will not be able to return to a decent life.

On the treatment and rehabilitation after the spinal compression fracture in Germany
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