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Spine injuries. Rachis change
December 18, 2012
Spinal fractures in medicine are considered as heavy injuries of a skeleton. Rather often spinal fracture is combined with injury of muscles, sheaves, intervertebral disks which are located near it. But also other spine injuries owing to which at patients serious consequences are noted are often diagnosed.
The backbone of the person is the main support of a skeleton and its at the same time main part. It is made by separate bones (vertebrae) connected by continuous and preryvny connections. Between vertebrae intervertebral disks which are peculiar elastic shock-absorbers at loads of a backbone are located. The rachis consists of five departments: cervical, chest, lumbar, sacral, coccygeal. Let's consider in more detail features of injuries and spinal fractures.
Reasons of spine injuries
Spine injuries are diagnosed rather often. At the same time in 20-35% of cases of damages at a spine injury there is also a damage of a spinal cord of the person. Such injuries have afterwards very serious influence on health of the patient.
There are many reasons because of which there can be an injury of a backbone. As a rule, the majority of such injuries is connected with modern development of technologies. So-called injuries of "diver" are often diagnosed. In this case the spine injury is connected with jumps in a reservoir. The person, without knowing features of a bottom, hits against barriers at the bottom of-headed. At its zaprokidyvaniye body weight injures a backbone. As a result, there is an injury of cervical department of a backbone.
Often such injuries occurs at road accidents. And, are injured as those who stay in the car, and passengers.
Spine injuries occur also when falling from height. But most seriously the backbone suffers if the person when falling landed on legs. In this case sharp impact of body weight on a backbone is noted, and there can be its compression change. Spine injuries arise also at wounds – knife, fire, etc.
One more kind of such injuries — a birth trauma of cervical department of a backbone and spinal cord which is carried to perinatal defeats of TsNS. It arises in the course of childbirth at which there are big overloads for the child owing to resistance of muscles of patrimonial ways.
Specialists classify spine injuries, being guided by several different criteria. Estimating localization of an injury, they allocate injuries of cervical, chest, lumbar departments of a backbone, and also the combined spine injuries at which several departments were struck.
Injuries also subdivide on such where there was an injury of a spinal cord and where such damage was not.
Estimating defeat depth, doctors allocate the defeats hanging at which takes place the damage of integuments and underlying structures and also which are not getting at which integuments remain whole.
Also several types of spine injuries are allocated: bruises, dislocations, fractures, gaps.
The main clinical symptoms at spine injuries is the pain arising as in the place of defeat, and pain on all back. Also at the patient symptoms of neurologic pathology are shown. At the same time injuries of a spinal cord can not be, but at a spine injury there is a hypostasis squeezing a spinal cord or nerves departing from it.
At a spine injury dysfunctions of a spinal cord are observed, but their features directly depend on where the injury is localized.
The most dangerous symptoms for life of the patient appear in case of an injury of cervical department of a backbone. At the victim breath, and also cordial activity can be broken, and, there is a risk of a cardiac standstill. There can be body paralysis, functions of internals will be broken. At easy defeats of this otel of a backbone sensitivity is broken, an animal force decreases. The spastic muscle tension is sometimes shown. As a result, the movements are limited, and at a long tension the structure of muscles changes, and, this state can forever remain.
At injuries of chest department of a backbone sensitivity and mobility of hands and a thorax is broken, also legs in certain cases suffer. The victim feels backbone pain, it periodically gives to the area of heart. Sometimes pain is shown also at a breath exhalation.
At injuries of lumbar department of a backbone an animal force can weaken, and sometimes there is paralysis of the lower extremities. Disorder of sensitivity is shown, force of reflexes goes down, there can be spastic phenomena. Besides, disturbances in work of urinogenital system take place. It is shown by urination delays, an urine incontience, erectile dysfunction, lowering of sensitivity of generative organs.
Traumatization of a backbone can occur at the same time in several dreams. Respectively, and symptoms in that case will be mixed.
Effects of spine injuries, and also duration of manifestations depends on some factors. It is localization and weight of damages, involvement of a spinal cord in process, weight of a condition of the person, timeliness of first aid and the correct approach to it.
For the first weeks after an injury of the patient suffers from pain in the place of damage, and also from others, the manifestations described above. Often at a similar injury the long immobilization (full immobilization) practices in order that changes grew together rather.
However the main effect of spine injuries is neurologic deficit which takes place at the patient throughout a long time or all life. It is paresis, paralyzes of extremities, sensitivity disturbance, the spastic phenomena, disturbance of work of internals, instability of a backbone, etc.
Recovery of a backbone the field of injuries takes a long time, it is gradual, sometimes very disease process. But with use of a number of effective methods (special physiotherapy exercises, reflexotherapy, manual therapy) the lost functions can be returned at least partially. It is important to address the specialist after traumatized as soon as possible, the success of recovery to a large extent depends on it.
Spinal fracture is considered especially serious injury. His falling from height is a basic reason of spinal fracture at the person if it falls on the head, buttocks or legs. Gave a change of cervical a backbone often occurs at a so-called "hlystovy injury" which happens in road accident. If the car sharply stops, then the body of the person holds a seat belt, and the head moves sharply forward. At such injury also sometimes there is a fracture of chest vertebras. Also spinal fractures can occur when squeezing and a direct injury.
Classification of spinal fractures
Spinal fractures subdivide not fractures of vertebras at which there is no injury of a spinal cord, and on changes to its damage. Changes are sometimes combined with damage of nervous roots and intervertebral disks.
At the isolated spinal fractures one vertebra is injured, at multiple — a fracture of two vertebras or their bigger quantity.
Also stable and unstable changes are classified. If the patient has an unstable change, then front and back departments of a vertebra are at the same time damaged. As a result, the backbone can be displaced. At a stable change stability of a rachis remains as occurs a change or lobbies, or back vertebrae.
If at a change there was no injury of a spinal cord, then the person is disturbed by a dorsodynia which at movement of the body becomes stronger. Smoothing of contours of a back furrow or small hypostasis can sometimes be noted where there was a damage. At cough or deep breath pain amplifies. At changes pain can sometimes irradirovat in a stomach. A characteristic symptom is the morbidity in the place of a change arising at easy pressing on the victim's head. However such reception cannot be made independently.
If the movements, functions of pelvic bodies or their sensitivity are broken, then the speech already goes about the injured spinal cord.
Owing to serious compression spinal fracture in the future at the patient segmented instability at which pain disturbs can be observed, there are degenerative changes.
The people of advanced age who had spinal fracture can have "a senile hump" and chronic backbone pains.
The heaviest complication — a gap, and also squeezing of roots or a spinal cord. If the gap arises only during an injury, then squeezing can happen later. Owing to squeezing food of fabrics is broken, the vertebral channel is gradually narrowed and the myelipathy is shown. This neurologic disturbance is eliminated only with an operational method.
It is possible to confirm the diagnosis in case of spinal fracture, having conducted radiographic research. If the doctor suspects that the patient had an unstable spinal fracture, to it carrying out a computer tomography is appointed. Backbone MRT allows to define damages of roots and a spinal cord.
Each person has to realize accurately that spinal fracture is a serious injury which effects can be felt throughout all life. Therefore it is very important to provide timely treatment of a disease. If first aid at a change was given professionally, and therapy and the subsequent rehabilitation was made under a constant control of specialists, then the change of cervical department, and also other departments of a rachis leaves the minimum quantity of unpleasant effects.
Traumatologists most often fix so-called compression spinal fracture at the patient. In this case there is a squeezing, and height of a body of a vertebra becomes less. Splintered fractures of vertebras are less often diagnosed.
Compression spinal fracture at children and young people occurs, as a rule, owing to serious injuries. At people of advanced age effects of osteoporosis undetected in time quite so can be expressed. In that case the compression change can occur even under the influence of a body weight of the person or other, apparently, insignificant influences.
Treatment of compression spinal fracture is carried out at observance of the high guarding security. Special corsets, and also reklinator are for this purpose used. The doctor appoints analgetics to relieve the patient of severe pain. Often the patient has to observe a bed rest which drags on for weeks. Several months the patient cannot lift weights, to do sharp inclinations and turns of a trunk, to sit. But nevertheless in certain cases it is not possible to do without surgical intervention.
Important stage of treatment and prevention of complication of this type of a change are the physiotherapy exercises. The patient regularly carries out the set of exercises directed to strengthening of a muscular corset under the leadership of the specialist. Besides, by means of such exercises it is possible to activate blood supply that promotes regeneration of the damaged elements. Except LFK also physiotherapeutic procedures and courses of massage are appointed.
At treatment of changes of cervical department of a backbone in case of an uncomplicated change to the patient impose a plaster corset or a collar of Shants which needs to be carried till 4 months on a neck. If heavy damages took place, then the fixing operative measures at which use special plates or fixers are carried out.
Splintered spinal fractures are diagnosed less often, but are very heavy changes. At such injury the vertebra body breaks up into several fragments. In this case surgical treatment is carried out.
Section: Orthopedics and traumatology