How are thoracolumbar spine fractures caused?
Spine fractures can be caused by a variety of mechanisms. Common causes of spine fractures are
-Road traffic accidents
-Fall from a height
-sports accidents, Gunshot wounds
The spinal cord may also be injured, depending on the severity of the fracture.
Spine fractures require high energy trauma and associated injuries are the rule rather than the exception.
Spine fractures, however, can also occur due to minimal trauma in the elderly when the bones are weakened by osteoporosis or other conditions like tumor or infection.
Are thoracolumbar spine fractures serious injuries?
The thoracolumbar spine forms the rigid bony column which serves the important function of protecting the spinal cord and nerves going to the limbs as well.
In about 30% of thoracolumbar fractures there is associated spinal cord injury leading to paralysis of the lowerlimbs and loss of bowel and bladder function. Loss of neurological function make these injuries serious requiring treatment at specialised centres.
Because of the high-energy mechanism of injury, patients often have other life-threatening injuries as well.
What are the first aid measures in thoracolumbar spine fractures?
Never attempt to move a person with a spinal injury because movement can cause more damage. It is important that the patient be transported at the earliest to a center specialised in spinal injuries, preferably by trained personnel. Unprotected movement of the injured spine can cause fresh damage to the nerves or worsen existing damage.
What are the symptoms of thoracolumbar spine fractures?
The primary symptom is moderate to severe back pain that is made worse by movement. When the spinal cord is also involved, numbness, tingling, weakness of the limbs, or bowel/bladder dysfunction may occur.
What is to be done when the patient reaches the hospital?
Doctors in the emergency room or Casualty will take adequate precautions to protect the spine while they proceed with a detailed examination which includes an ample history both regarding the accident as well as previous medical history, other diseases and medication. A complete spine examination requires the patient to be undressed and thoroughly examined for both spine and other limb injuries.
A detailed examination of the spinal cord and spinal nerve functions will be done to check the nature and extent of the cord injury. This serves as a guideline to decide treatment as well as gives an idea regarding the prognosis of recovery of neurological function.
What investigations are generally done for thoracolumbar spine injuries?
X-ray examinations of the entire spine from multiple angles may be necessary to see bone alignment and check for damage to soft tissue. Computed tomography (CT) or magnetic resonance imaging (MRI) scans are required to help the doctor better visualize the injury. The CT clarifies the bone picture while the MRI delineates the extent of spinal cord and nerve damage. This helps doctors classify the injury and then decide the line of management.
How are thoracolumbar spine fractures treated?
Treatment goals in thoracolumbar spine injuries include
-Protecting nerve function
-Restoring alignment and stability of the spine.
-Allowing the patient to return to pre-injury activity at the earliest.
The doctor will determine the best treatment method based upon the type of fracture and other factors. In certain fractures, Early surgery may be the treatment of choice especially in fractures which are unstable or associated with spinal cord or nerve injury.
What will be done during surgery for spinal injuries?
Surgery realigns the spinal column and holds it together using metal plates and screws (internal fixation) and/or spinal fusion. This serves many purposes, chief among these being
-Relief of pressure on the nerves and the spinal cord making it conducive for early neurological recovery.
-Stability of the fractured spine to decrease pain on movement and allow the patient to sit and stand as early as possible.
Can spine fractures be treated without surgery?
Some low-energy thoracolumbar fractures especially those in the elderly due to osteoporosis can be treated with a short period of rest followed by mobilisation in a brace or corset. Admission may still be required to tide over the acute pain and to investigate whether there are any underlying disease processes.
What is the treatment for paralysis due to spinal cord injury?
Paralysis is one of the extremely disabling complications of cervical spine trauma. The cord injury may be complete or incomplete and surgery forms only the first part of the treatment. Further treatment includes specialised physiotherapy and nursing with adequate patient education by trained personnel. There are multiple complications associated with paralysis if the patient is inadequately monitored and treated. These include bedsores, urinary infection and lung infection. Patients with permanent paralysis also require rehabilitative support to get back to a near normal life.
Our hospital specialises in treating all types of thoracolumbar spine fractures and has scientifically proven protocols to decide whether surgery is required or not. We are also equipped with the latest equipment including intra-operative fluoroscopy and computer navigation to make spinal trauma surgery safe, effective and efficient. Our rehabilitation team also provides support and rehabilitation for the paralysed patients to make it back on the road to recovery.
This information is provided by Ganga hospital and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. For additional health information, please contact the hospital (0422-2485000) to book an appointment to see a doctor. This document was last reviewed on: 1/05/2008
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