Spine fractures are one of the most dangerous type of fractures. The bony cage that protects the spinal cord from injury from the exterior is damaged, thus increasing the chances of neurological damage resulting in weakness of the limbs. Most common causes are fall from height and road traffic accidents. In pathological spine, i.e., in patients with osteoporosis, bone tumours etc. can sustain fractures with very trivial injury.
These fractures require emergency treatment in special Orthopaedic centres. Depending on the neurological deficit and the condition of the patient surgery will be planned. There are a group of stable fractures, where there is less chance of neurological deficit and fracture healing is good. These fractures can be treated conservatively. Non operative management generally includes complete bed rest for 48-72 hrs or up to 3 weeks depending on the fracture pattern, along with bracing support for another 3 months.
In those with neurological deficit or in those with unstable fracture patterns operative treatment is required. This usually involves stabilizing the fractured bone with special titanium screws. If this is done to stabilize a fracture alone then usually the patient will be able to walk in around 2 days. Those with neurological deficits require special techniques to decompress the pressure on the spinal cord. The recovery of the neurological deficit depends on the severity of the problem at the time of injury. The rule of thumb being lesser the deficit at the time of injury faster will be the recovery to a normal level after surgery.
Restoring their mobility and making them ambulate is extremely important because if left untreated these severe injuries can result in pneumonia, bed sore, block in blood vessels (DVT) and urinary tract infections etc. which can eventually cause life risk.
CT scan and X-ray of unstable burst fracture D12 vertebrae. The third picture shows restoration of fractured bone by special titanium screw technique.
|X- ray showing Fracture dislocation L3 over L4, the second picture shows Post surgery x-rays.|