Vehicle accidents and falls are a major part of spinal trauma. These accidents can cause one or several vertebrae to break and crush. It may be in the neck, back or lower back. Sudden onset of the neck, back or low back pain after trauma is typical. Sometimes fractures are seen in patients with bone loss, although there is no significant history of trauma.
Motor vehicle accidents
Falling from high
Osteoporotic bone fracture
Patients and doctors usually encounter in the emergency department in spinal fractures due to trauma such as falls and traffic accidents. Patients may have neck, low back or back pain depending on the location of the lesion. If the spine fracture has damaged the spinal cord or the nerves coming out of the spinal cord, the patient may have different forms of paralysis. The patient may not be able to move his arms or legs. Loss of sensation may also be added to this weakness. Urinary and defecation control may be impaired. In chronic fractures such as osteoporotic fractures, only pain may be seen.
The patient’s complaints, history of the disease and examination are very important in terms of diagnosis. In addition, some tests should be performed for diagnosis.
Fractures in the spine and alignment of the spine are seen in x-ray films. Collapses and slips may be seen in spine bones.
Computed tomography (CT) provides detailed information about the structures of the spine bones. It clearly shows broken bone fragments that have entered the spinal canal. It shows the amount, shape and type of fracture.
Magnetic resonance imaging (MRI) provides detailed information about soft tissues such as spinal cord, nerve tissue, cartilage, ligaments and connective tissue between the vertebral structures. Thus, if any, spinal cord damage and spinal cord’s condition, traumatic hernias accompanying spinal fracture, spinal cord or surrounding hemorrhage, connective tissue and ligament tears can be seen in detail.
After the patient’s complaint, history, and examination, radiological examination of the spine is performed. With these images, the classification of the fracture is done by obtaining information about the status of bone and ligament structures and spinal cord injury. In this way, after the diagnosis is made, it is decided what kind of treatment the patient needs.
If the patient has a spinal fracture that does not require surgery, bed rest can be applied for varying periods depending on the shape and location of the fracture. The use of corsets is usually added to the bed rest. The aim is to reduce the movement of the traumatized spine to accelerate its healing and to ensure that there is less pain. Painkillers can be used. Exercises can be performed under the control of wound care and physical therapy physician if available. In cases where medical treatment is not sufficient, surgical treatment is tried.
There may be fracture anywhere in the spine from the top of the neck to the sacrum. This fracture may be accompanied by slip, or only a collapse fracture may have occurred. The spinal cord can be crushed by broken bones in the canal. The vertebral body may be severely damaged after trauma as well as the back of the vertebrae may be broken. The condition of the spine and spinal cord is evaluated with details and the form and time of surgical treatment are decided. When making this decision, the patient’s general condition, previous illnesses and other organs injured in the event of the accident are also considered.
The goal of surgery is to restore the spine to its former function. The primary goal is to relax the spinal cord and nerve roots under compression. For this, bone fragments that step on the spinal cord are removed. The comminuted spine bodies are replaced by metal cages or supporting bone structures. In addition, the vertebrae may need to be fixed with titanium screws and rod systems to arrange the spine and to regain the load-bearing capability.