Vehicle accidents and falls make up a big percentage of spinal traumas. These accidents can cause one or several vertebrae to be broken and crushed. It may occur in the neck, the upper back or the lower back. Sudden onset of the neck, back or lower back pain after trauma is typical. Sometimes fractures are seen in patients with osteoporosis, although there is no apparent history of trauma.
Doctors usually encounter the patients in emergency rooms in cases of spinal fractures due to trauma such as falls and traffic accidents. Patients may have neck, lower back or upper 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. Sensation loss may also be added to this weakness. Urinary and fecal control may be impaired. In chronic fractures such as osteoporotic fractures, the only symptom may be pain.
The patient’s complaints, history of the disease and examination are very important in making a diagnosis. Additionally, certain tests must be performed for the diagnosis.
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 the spinal cord injury. In this way, after the diagnosis is made, a decision can be made regarding the type of treatment the patient requires.
If the patient has a spinal fracture that does not require surgery, bed rest can be prescribed for varying periods depending on the shape and location of the fracture. The use of corsets is usually added to bed rest. The aim is to reduce the movement of the traumatized spine to accelerate the healing process and to ensure that the pain is reduced. Painkillers may be used. Wound care and exercises can be performed under the control of the physical therapy physician, if applicable. In cases where medical treatment is not sufficient, surgical treatment is tried.
There may be a fracture anywhere in the spine from the top of the neck to the sacrum. This fracture may be accompanied by shift, or it may have occurred as a collapse fracture only. The spinal cord may be crushed by broken bones in the canal. The vertebral body may be severely damaged after trauma, and also the posterior parts of the vertebrae may be broken. The condition of the spine and spinal cord is evaluated with in detail and the form and timeframe of surgical treatment are decided. While making this decision, the patient’s general condition, previous illnesses and other organs injured in the event of the accident are also carefully considered.
The goal of surgery is to restore the spine to its former function. The primary goal is to relieve the spinal cord and the nerve roots under compression. For this purpose, bone fragments that exert pressure on the spinal cord are removed. 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 rearrange the spine and to restore the load-bearing capability. Grafts obtained from the body or from an outside source may be used to improve the bone union rate and increase the support.
