Treatment, rehabilitation, exercise therapy in the compression fracture of the lumbar spine
In the event that there was a compression fracture of the spine of the lumbar region, treatment should only be determined by doctors, as this is a dangerous condition that can bring many complications.
What is compression fracture of the spine?
Fractures of the spinal column are classified according to the direction of the traumatic force. Along with flexion-distraction and rotational damages, there are compression ones. Compression fracture is a fracture that has arisen as a result of compression of the spine, with deformation, squeezing, squashing, cracking in one vertebra or several.
More often with such fractures, the front vertebrae flatten and become wedge-shaped. The destroyed body of the vertebra can squeeze the nerve roots.
With a serious fracture, the deformed posterior part of the vertebra can penetrate into the spinal canal and act on the spinal cord, causing its damage. Often this process occurs gradually, so neurological signs may not appear immediately after trauma.
How can I get injured?
Distinguish the complicated and uncomplicated fracture of the spine. Uncomplicated is characterized by poorly expressed signs: the patient may experience pain of a non-intensive nature, which, in his opinion, do not require a doctor.
Compression fracture of the lumbar spine can be obtained as a result of:
- Trauma in an accident.
- Falls from height.
- Sports injuries.
- Gunshot wounds.
- Presence of osteoporosis, tumors of the spine and other pathologies that affect the strength of bone tissue and can cause a fracture in the course of usual actions.
The following actions, movements and injuries can lead to a fracture in the lumbar spine:
- A slight bump.
- Jump or fall with a landing on your feet or on your buttocks.
- Incorrect loading in sports.
Clinical manifestations of
But in the future such damage, if the necessary treatment has not been carried out, can lead to serious consequences. Complicated fracture is characterized by the fact that damaged vertebrae affect the spinal cord, intervertebral disc, blood vessels.
It is possible to determine the presence of fracture reliably only in the hospital, after carrying out hardware research. But when getting injured, you must be careful and follow the rules of first aid recommended for suspected fracture if the following signs are observed:
- Pain sensations at the site of damage of a different nature and intensity that increase during movement.
- Numbness and weakness, loss of sensitivity in the limbs.
- Children may have difficulty breathing and abdominal pain due to muscle tension.
Consequences of compression of vertebral fragments
Consequences of compression fracture of the lumbar spine:
- The instability of the vertebrae in the lumbar region is observed.
- The curvature of the spine, radiculitis, osteochondrosis develops.
- Complicated fracture can lead to stenosis( narrowing) of the spinal canal, which causes compression of the spinal cord with the outgoing roots, which causes neurological disorders such as pain and burning, radiating to the leg and buttock, numbness and weakness, impaired motor function, sensitivity of the lower limbs, violations of the excretory function of the intestine and bladder, paralysis.
Spine injuries are always dangerous and cause post-traumatic complications. Even an uncomplicated fracture, which can not be detected immediately, subsequently, especially if it has not been treated, can cause pathologies such as radiculitis and osteochondrosis.
First Aid and Diagnosis
Compression fracture diagnosis methods:
- An X-ray is necessary to confirm the diagnosis.
- Computed tomography is assigned for more thorough examination of the damaged department.
- To exclude or confirm damage to the spinal cord, a thorough neurologic examination and carrying out myelography - radiopaque examination of the liquor-conducting pathways of the spinal cord - is necessary.
- Magnetic resonance imaging is used to exclude damage to the structures of the spinal column.
When the diagnosis is confirmed, the doctor prescribes the necessary treatment.
In no case should you be engaged in independent treatment of such a serious condition, otherwise you can earn irreversible complications.
Therefore, a qualified specialist is needed.
Methods of therapy and recovery
After the exact diagnosis is made and all the recommendations necessary for treatment are given, the patient can be discharged. Further treatment and rehabilitation can be carried out at home.
What methods are used in the treatment of compression fractures? Compression fractures of the lumbar spine require an integrated approach to treatment.
- In the presence of severe pain syndrome, analgesics are prescribed.
- For a certain period the patient must comply with bed rest.
- To fix the spine and to maintain immobility and rest( to avoid displacement of the vertebrae, new damage), a corset is needed. It is made individually for each patient.
The course of treatment is approximately 3 months. The period of complete recovery depends on the degree of fracture and individual characteristics of the organism. On average, if the fracture has been treated correctly, a full recovery is 1.5-2 years. In children, this process is a little faster and easier, because the body constantly develops new tissues and all regeneration processes occur faster and more efficiently than in adults.
Restorative procedures include:
- Once the fracture has been treated, a reklinator can be prescribed - a means to correct posture, to prevent post-traumatic spinal curvature.
- Massage massage - is prescribed to strengthen the muscles, with the observance of prolonged bed restrain the development of pressure sores.
- Physiotherapy( LFK) - is one of the most important components of the recovery process after fractures. Exercise is recommended in a specialized institution under the supervision of a qualified physiotherapist, in order to achieve a more effective and quick effect.
- Physiotherapy( magnetotherapy, phonophoresis, muscle electrostimulation).
If you suspect a fracture, the first thing to do is fix the damaged spine. The patient should be at rest before the doctors arrive. It is necessary to call an ambulance for hospitalization and an accurate diagnosis.
If bone fragments form in the fracture, they can cut the nerve roots - then the neurological disorders will be irreversible. Therefore, you should know that any spinal cord injury requires timely and adequate treatment.
Surgical treatment of
In some cases of complicated compression fracture of the lumbar region, it becomes necessary to subject the patient to surgical treatment. The surgical procedure is called "vertebroplasty", it is used in violation of the integrity of the vertebra. Local anesthesia is used during the operation. Passes under constant radiological supervision.
Technology: a puncture is performed on the skin of the patient in the area of the damaged vertebra. A special metal conductor is introduced through it. With its help, a solution is introduced into the vertebral cavity, which serves to strengthen the vertebra. Vertebroplasty is an effective( 90%) treatment of compression fractures.
Another method of operative therapy is kyphoplasty. On the skin 2 cuts are made, through which a balloon is introduced into the cavity of the vertebra. After being placed in the vertebra, the balloon is inflated and filled with a solution to fix the position and size of the vertebra. It is necessary treatment, if it is necessary to restore the height of the vertebra in full or in part, or to correct its position.
How to treat a compression fracture of the spine
Stenosis of the lumbar spine http: //pozprof.ru/bn/ ctenoz.html # t2.
Surgical treatment of compression fractures of the spinal column is indicated by compression of the nervous structures( spinal cord, nerve roots), instability of the spinal column, and severe pain syndrome. For example, when the height of the vertebral body is reduced by more than 50% on the radiographs, instability of the spine arises, which can lead to compression of the nerve structures. In this case, the operation is needed to prevent trauma to the nerve roots and the spinal cord. There are several types of operations that are performed with compression fractures of the spine. Depending on the type of fracture of the vertebrae, the degree of squeezing of the nerve endings, the doctor can choose one or another type of operation. The main principles of surgery for trauma to the spine are the removal of compression of the nerve structures( if there are symptoms of compression of the bone structures of the spinal cord or nerve roots), and stabilization( fixation in a physiologically beneficial position) of the damaged vertebral segment.
Front access. When compressing the spinal cord in front of the crushed vertebral body, the surgeon performs the operation usually from anterior access. In this case, the incision is made on the anterolateral surface of the abdomen or thorax. Then the body of the damaged vertebra is exposed. The removal of bone elements that squeeze the bone marrow is carried out. After decompression, the spinal column stabilizes. To do this, a bone graft is attached to the site of the remote, fractured body of the vertebra. To date, a wide application is found for grafts made from the patient's own bone( autoruns), as well as from specially treated cadaver bone( allografts).Increasingly popular for the stabilization of the spine are conquering cages - artificial prostheses of vertebral bodies or discs. Keiji are made of durable artificial materials or titanium. Cage is clogged with bone shavings, which is taken from the crest of the pelvic bone, a special cutter. After a few months, the graft consolidates with the bodies of the lower and upper vertebrae into a single bone structure( conglomerate).Stabilizing systems are used to fix the graft and the damaged vertebral segment in a physiologically correct position, which can consist of plates, lintels and beams. The components of the stabilizing systems are made of titanium or alloys( titanium carbide) - strong, inert( non-active) materials that do not cause rejection reactions on the part of the body.
Rear access. Often, the stabilization of the spine can be carried out through a cutaneous incision in the back( rear access).This operation of back access is performed most often in the absence of a dorsal anterior compression of the spinal cord by parts of the damaged vertebral body. Internal fixation of the damaged vertebral segment in a physiologically correct position with the help of special stabilizing systems helps to prevent damage to nerve structures( spinal cord or roots), to provide early activation of the patient, to help the optimal fusion of bone structures. In most recent years, transpedicular stabilization of the spine has been used in surgical practice. With this technique, the fixing screws are fixed through the legs of the vertebrae in the body of the vertebra. The screws on each side are connected by strong beams, which unite the vertebrae into a single conglomerate. These stabilizing systems differ from others in their strength and reliability, which makes it possible to activate the patient from the first days after the operation.
LFK with compression fracture of the vertebra of the thoracic or lumbar spine is one of the main methods of rehabilitation of patients with these injuries of the musculoskeletal system. The main advantage of therapeutic exercise is high efficiency. Well, the minimum expenditure serves as an additional argument in favor of a wide popularization of exercise therapy at all levels of the treatment and recovery process.
LFK at a compression fracture of a vertebra in a thoracal or lumbar department of a backbone first of all is directed on increase of force and endurance of muscles of a trunk, and further and on increase in mobility of a backbone. In addition, exercise therapy for compression fracture of the vertebra is part of preventive measures aimed at preventing the formation of bedsores, reducing the phenomena of a common asthenic syndrome, preventing thrombosis and normalizing the digestive process.
Timely and sufficient duration of the exercise complex for trauma to the thoracic and lumbar spine prevents the attachment of congestive pneumonia and / or the development of dysfunction of the pelvic organs.
Introductory part: initial position( and so on) - lying on the back.
Straighten your arms inward - inhale, arms forward and down - exhale.8-10 times.
Slowly flex the arms in the elbow joints with the tension, leading the brush to the shoulders.8-10 times. Back and plantar flexion of feet.8-10 times.
Leaving the hands to the side with one-stage turn of the head in the same direction. Raise your hands - inhale, lower - exhale.8-10 times.
Bend the leg in the knee joint, pull it up and lower it.11-15 times.
Removing and bringing a straight leg.8-10 times.
Straight arms are spread apart at shoulder level and are slightly retracted. Small circular movements of the hands with some slight tension of the muscles of the back and shoulder blades.8-10 times.
Hands bent at the elbows with an emphasis on the bed. Bending in the thoracic spine with support on the elbows and forearms.8-10 times.
Hands on hips. Imitation of riding a bicycle. Movement with your legs only alternately!8-10 times.
Diaphragmatic breathing.5 times.
Isometric tension of the ham muscles 5-7 seconds.5-6 times.
Squeezing and squashing fingers.12-15 times.
Raising a straight leg to an angle of 45 degrees and holding it for 5-7 seconds.4-5 times.
Diaphragmatic breathing.5 times.
Isometric tension of the calf muscles 5-7 seconds.4-5 times.
Raising hands through the sides upwards - inhale, return to the starting position - exhalation.6-8 times.
I.P. - lying on the stomach.
The arms are bent at the elbows, forearms on the plane of the bed. Torso of the trunk in the thoracic region.6-8 times.
Lifting the head and shoulders.8-10 times.
Alternate retraction of the back of a straight leg.8-10 times.
Isometric tension of the back muscles 5-7 sec.5-6 times. Passive rest - 2-3 min.
I.P. - standing on all fours.
Alternate laying straight hands in the sides.8-10 times.
Sequential lifting of hands upwards, with simultaneous raising of a head and a bending of a back.8-10 times.
Alternate circular movements with hands.8-10 times.
Alternately lifting a straight leg.8-10 times.
Raising a straight arm up with a simultaneous lifting of a dissimilar straight leg.8-10 times.
Moving on all fours forward, backward.
Movement on the hands to the right, to the left, the legs remain in place - the so-called "bear step".
Duration of training 40-45 minutes.
Constantly follow the posture! You can sit in 3-3.5 months, for a short time several times a day. Up to 3.5 months are forbidden to incline forward. In the future, classes in the pool( preferably daily).Follow up with a traumatologist for up to 6 months.
In the complex of restorative treatment used in the process of medical rehabilitation of patients with consequences of injuries and diseases of the spine, therapeutic gymnastics plays a leading role.
The use of physical exercises with a therapeutic purpose is carried out in accordance with the procedure of rehabilitation therapy for this disease and its individual manifestations in individual patients.
Complexes of physical exercises and separately special exercises are selected taking into account the nature of damage, the time from the moment of trauma or surgical intervention, age, clinical features of the disease, etc.
The dosage of the load when applying physical exercises, the choice of the starting position and the various types of exercises of therapeutic gymnastics must vary depending on the individual characteristics of the patient and the course of the illness.
Mending massage with compression fracture of the spine. This procedure promotes:
to strengthen the muscles of the back;giving them a tone;prevention of pressure sores.
In the period of immobilization for the prevention of pressure ulcers, stroking and grinding with camphor alcohol of the area of the sacrum, buttocks, back, putting rubber circles under them.
Massage is prescribed in the subacute period( after 5-6 weeks).First, massage the chest( all receptions gently), then back( stroking and rubbing), stomach( all receptions) and limbs. With the spastic form of paralysis( muscle paresis) for muscles with high tone, planar and circular stroking, superficial embracing stroking, longitudinal kneading and felting, and for the muscles-antagonists - stroking, triturating, transverse kneading, effleurage are used. In the case of peripheral paralysis, kneading, twitching, shearing of muscles, rubbing of tendons and joints are used. The massage procedure lasts 10-20 minutes daily or every other day, 10-12 procedures.
In the diet of a patient who has undergone a compression fracture of the spine, the advantage should be given to products with a high content of the following trace elements and vitamins:
Calcium. It is found in dairy products, almonds, cabbage, salmon fish.
Magnesium. Its a lot in nuts, leafy vegetables, bananas, shrimp.
Zinc. A lot of zinc contain seafood, there is zinc in buckwheat and oatmeal, walnuts.
Folic acid and vitamin B 6. Contained in the liver, bananas, beans, cabbage, beetroot.
All these vitamins and trace elements contribute to the rapid formation of bone callus and healing of the fracture.
There is also a list of products that should be excluded from eating t patients with fractures. It:
Coffee, strong tea, lemonade. Caffeine helps wash away calcium.
Fatty foods. Fat prevents calcium properly absorbed.
Alcohol. Disrupts the work of cells, contributes to their destruction.
In conclusion of the article I want to say a few words about the prevention of compression fractures. First of all, it is observance of caution in sports and active rest, in old age - prevention and treatment of osteoporosis. And, of course, food rich in calcium!
Complex of exercises for compression fracture of the spine
Exemplary set of exercises for compression fracture of the spinal column in the first stage of treatment
Initial position lying on the back
- Hands along the body palms up. Clenching the fingers in a fist, bend the arms in the elbow joints, the toes of the feet "to themselves"( the rear flexion in the ankles).8-10 paз.
- Hands on hips. Alternate bending of the legs in the knee joints with the support of the feet on the bed.6-8 times.
- Hands to shoulders, fingers clenched into fist. Circular movements in the shoulder joints. In each side 4-6 times.
- Hands on hips. A slight deflection, in the upper part of the thorax.4-6 times.
- The palm of the right hand on the chest, the left one - on the stomach. Deep breathing. The pace is slow. Hand control movement of the diaphragm and ribs.5-6 times.
- Hands along the body with the palms facing down. The legs are bent at the knee joints, one foot on the toe, the other on the heel. Simultaneous lowering of one heel and lifting the other and vice versa.10-12 times.
- Hands in front of the chest. Alternate hand sideways with a simultaneous turn of the head in the same direction.5-6 times.
- Hands on hips. Legs on the width of shoulders, socks on themselves. Pronation and supination with touching the bed with an internal or external arch of the foot( first separately with each foot, then with two legs simultaneously).6-8 times.
- The legs are bent at the knee joints. Put your hands on the edge of the bed. Leaning on the back of the head, shoulders and feet, raise the pelvis.3-5 times.
- Hands on the waist. Alternate removal of legs, without lifting them from the bed. Each leg 4-6 times.
- The arms are bent at the elbow joints, forearms and hands are perpendicular to the plane of the bed. Simultaneous bending of one hand, touching the shoulder with a brush, and extension of the other, touching the bed with a brush.6-8 times.
- Calm deep breathing.
Exemplary set of exercises for compression fracture of the spine in the second stage of
A month after the
trauma, the lumbar spine is lying on the back.
- Hands along the body. Hands through the sides to lift up, stretch 5-6 times.
- Hands on the waist. Back and plantar flexion in ankle joints.10-15 times.
- Grabs his hands behind the headboard. Simultaneous bending of the legs in the knee joints, sliding on the bed. With extension - back flexion in the ankles.8-10 times.
- The arms are bent at the elbow joints, forearms and hands are perpendicular to the plane of the bed. Leaning on the head, shoulders and elbows, bend over in the thoracic spine,( do not raise the pelvis).Hold this position for 10-15 seconds.3-4 times.
- Grabs your hands on the edge of the bed. Imitating feet riding a bicycle( legs raise no higher than 45 °).12-20 times.
- Calm deep breathing and muscle relaxation. Recreation.
I.P. - lying on the stomach.
- The arms are bent at the elbow joints. Leaning on the hand and forearm, raise the head and shoulders. Hold this position for 10-15 seconds.4-6 times.
- Hands along the body. Bend the leg in the knee joint( stop in the rear bending position).Straighten it, lift it from the bed and slowly lower it, placing the foot on the fingers. Each leg 6-8 times.
- Hands to shoulders. Raise the head, shoulders and upper body, connect the shoulder blades. Hold this position for 10-15 seconds.4-6 times.
- With your hands, grasp the vertical pillars of the headboard to lift the straight legs. Movement, imitating swimming style krol. Each leg 10-15 times.
I.P. - lying on the back.
- Calm deep breathing and muscle relaxation. Recreation.
- Grabs your hands on the edge of the bed. Raise the straight leg to an angle of 45 ° to the plane of the bed( stop in the rear bending position).
- Write in the air heel figures from 1 to 6. Each foot 2-4 times.
- Hands on the waist, the head is lifted from the bed. Slopes of the trunk to the sides, sliding back on the bed( make sure that the pelvis and legs remain motionless).6-8 times.
- Hands along the body. Simultaneous bending of the right leg in the knee joint, tearing off the foot from the bed( sock to itself), and the left arm in the elbow joint.10 -12 times. Same left foot and right hand.
- The arms are bent at the elbow joints, the legs are at the knees. Leaning on the head, shoulders and feet, raise the pelvis and straightened leg. Each leg 3-5 times.
- Hands up with a simultaneous retraction of a straight leg with each foot 4-5 times.
- Grabs your hands on the back of the bed from the sides. Raise straight legs( socks on yourself), dilute, reduce and slowly lower, relaxing the muscles.
- Calm breath, relaxation of muscles. Recreation.
I. n. - lying on the stomach.
- Hands along the body. Raise the head, shoulders and upper body. Hold in this position, changing the initial position of the hands: to the shoulders, behind the head, up and to the sides.4-6 times.
- Hands to the shoulders. Raise head, shoulders, upper body and leg. Each leg 6-8 times.
- Grabs his hands on the back of the bed from the side, his legs are bent at the knee joints, the legs are perpendicular to the plane of the bed. Alternate maximum lifting of the legs, not bending them in the knee joints Each leg 6-8 times.
- The arms are bent at the elbow joints. Raise the head, shoulders and upper body. Keeping this position, hands make movements that mimic swimming style breasts.
- Hands up-sideways. Raise your arms, torso and both legs( "swallow") from your bed. Hold this position for 10-20 seconds, and in the last attempt the maximum time. In the following days, add 5-10 seconds.6-8 times.
- Calm breathing, relax your back muscles. Recreation.
I.P. - lying on his back.
- The leg is bent at the knee joints with the foot propped against the bed. Free movement of the legs to the right and left 6-8 times.
- Turns the head to the sides. In each side 4-6 times.
- Hands along the body palms up. Exercise for attention and coordination of movements: 1 - left hand to shoulder;2 - the same right;3 - left arm up;4 - the same right, 5 - left to the shoulder;6 - the same right;7 - left down;8 - the same right. Constantly speeding up the pace, repeat 4-6 times.
After finishing work, wipe the body with a damp towel.
Special exercises in resting position on the knees with compression fracture of the spinal column ( third stage)
- Alternate drawing of the hands in the sides with simultaneous raising of the head.
- Alternately lifting the straight arms up with a simultaneous raising of the head.
- Alternate circular movements with straight hands with a turn of the head in the same direction.
- Alternately lifting the straight legs back.
- Alternately lifting the straight arms up with the simultaneous lifting of the opposite leg back.
- Alternately lifting the straight arms up with the simultaneous lifting of the same leg backwards. When performing these exercises, the back should be bent;the accepted positions of the arms and legs must be held for 5-7 seconds.
- Movement in the stop, kneeling forward and backward.
- Movement in the stop standing on the lap in a circle to the right and left.
Special exercises in the position of kneeling with compression fracture of the spinal column ( third stage)
- Hands to the shoulders. Circular movements in the shoulder joints forward and backward.
- Torso bends to the right and to the left.
- Hands on the waist. Turn right, right hand to the side. Same to the left.
- Feet for shoulder width, arms to shoulders. Turn right, hands up - sideways. Same to the left.
- Moving on the lap forwards and backwards.
- Moving on the lap in a circle to the right and left.
All exercises in the standing position on the knees should be performed with a lumbar loin and a slight delay at the extreme point of the movement.
First aid for a fracture of the spine. Treatment and exercise therapy for the recovery of the spine
- LFK with a fracture of the spine
A violation of the integrity of the bone tissue of the spinal column due to trauma or disease is called spine fracture .The vertebral bodies serve to protect the spinal cord from various kinds of injuries, they are united by ligaments and cartilaginous tissue.
During the injury, in addition to the vertebrae, soft tissues( ligaments, cartilage, muscles) suffer, and sometimes nervous structures also get injured.
Fractures are divided at the site of the localization of the injured vertebra to the fractures of the sacral, coccygeal, lumbar, cervical and thoracic areas.
If several vertebrae have suffered, then such a fracture is plural. Isolated fractures are called, accompanied by a trauma of only one vertebra.
By type of damage there are crushed, compression, mixed type and fractures accompanied by dislocations. They can occur with or without injury to the spinal cord.
Compression fracture of the spine
Spinal injury, accompanied by squeezing one or more vertebrae, is called a compression fracture.
Compression fracture causes a strong overload, acting along the axis of the spine and sharp bending of the spine. Such an injury can be obtained during an accident, when falling from a high altitude, an unsuccessful jump.
Sometimes, this development is caused by the development of osteoporosis, which causes the loss of vertebral density and their low resistance to squeezing, in a similar case, a fall from the stool can lead to a fracture. Another factor that provokes damage of this kind is metastases in cancer lesions.
As a result of compression of adjacent bodies, the vertebra takes the form of a wedge and decreases in height, the bodies of the vertebrae are displaced. There is a curvature of the vertebral canal and there are disturbances in the functioning of the spinal cord.
Immediately at the time of , when an injury occurs, severe pain and difficulty with breathing occur, in the event that the spine is damaged in the waist or chest area. In the prone position, the pain weakens, and in standing or walking it intensifies.
Possible spread of painful sensations in the abdomen, vomiting, nausea, numbness of the limbs, pain in the head. Muscles of the back are tense, it is difficult to rotate the body.
If the fracture is not cured, the growth of the affected person, the formation of a hump, may occur in the course of time.
Degrees of spinal fractures
Depending on how much the height of the damaged vertebra was reduced, the compression fracture uncomplicated with spinal cord trauma is divided into three degrees:
- First degree, or small compression - a reduction of 30% or less
- Second degree, or moderate compression -, than on 50%
- the Third degree, or considerable compression - reduction on 50% and more.
Fracture of the lumbar spine of theApproximately 50% of vertebral fractures occur in the lumbar region, because it undergoes the most significant stress and often suffers from degenerative-dystrophic diseases.
Such a fracture can result in a jump from a great height to straight legs, a significant weight drop on a bent back, an automobile accident.
Symptoms of damage are
- Painful sensations when the body is tilted or rotated
- When pressure is applied to the injured vertebrae, a pain sensation arises
- Tenderness, sometimes they can spread to the limbs of
- Below the site of the injury, loss of sensitivity may occur, immobilization
- Violations of urination and stool, bloating,abdominal pain
- In the event that the cause of the fracture is osteoporosis, the patient feels a moderate soreness, but it gradually increases.
- If the spinal cord of the lumbar region is affected, then the functioning of the internal organs of the pelvis begins to be disrupted.
First aid in case of a spinal fracture includes the following measures.
- Removal of the injured person from the scene. For proper assistance, at least three people are needed. Take out the victim must be neat, placing his hands under his head, limbs and sacrum. The number of shifts must be minimal. If there is an opportunity immediately to transfer the patient to a stretcher, it is carried out by bringing them under the elevated side of the body.
- The injured person should be put on a hard, level surface, fix the spinal column and call an ambulance.
- If possible, relieve pain with any analgesic drugs at the maximum dose, even analgin will do.
- It is necessary to wrap the victim to avoid hypothermia.
- It is better not to move the victim before the arrival of an ambulance, unprofessional transportation can make the injury even more serious.
- If there is only a soft stretcher, then the victim is moved to them, putting on the stomach, and placing a soft roller under the chest, but this is an undesirable option, since it does not allow you to follow the facial expressions and breathing of the victim.
- It is necessary to fix the neck in case of traumatization of any part of the spine, as unwanted involuntary movements will affect the entire vertebral column. The collar can be made independently of cardboard, its height is equal to the length of the neck, it is necessary to layer cardboard with a soft material.
- In case of fracture of the spine in the region of the tailbone, the victim is transported in the supine position.
- In no case should the injured be put on their feet, planted, try independently to fix the spine, pull on the limbs, give medicines if the person loses consciousness or can not swallow, feed and water.
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Treatment of a spinal fracture
For an accurate diagnosis, a traumatologist prescribes a radiograph that allows you to determine the degree of damage and the location of the affected vertebra.
For the treatment of simple fractures of the first degree, conservative methods are sufficient, consisting in using analgesics and performing therapeutic physical training. To sleep it is necessary on a rigid bed, located at a small angle.
After about six weeks, physiotherapy and massage are prescribed. Two months a patient should wear a corset that will help fix the vertebrae in the correct position of the .In six months, the work ability of the victim is usually restored.
For moderate compression, skeletal traction is carried out using a special rigid surface that is sloped. With the help of straps the patient is attached to it for 8 weeks. After 10 weeks, additional warming and therapeutic massage are prescribed. Eight weeks later, with a dressed corset, the patient is allowed to move.
With a significant degree of compression, a gradual or forced expansion of the vertebrae is carried out by monitoring it with the help of an X-ray. Preliminary, they carry out the Novocaine blockade and put on a corset.
Fractured fractures are also treated as compression fractures, but recovery times increase to a year.
In severe cases, for example, with damage to the spinal cord or in the case of a multiple fracture, surgical intervention is performed. If the vertebra is not recoverable, then bone grafts are used.
After the operation, the rehabilitation period begins, designed to restore the flexibility of the spine, and based on physiotherapy and physical therapy.
LFK with fracture of the spineTherapeutic physical training is carried out after the main treatment, during the rehabilitation period. Its goal is to restore the flexibility of the spine, ligaments, to develop the mobility of the vertebrae, to strengthen the muscular corset.
Classes of physiotherapy exercises in the fracture of the spine are divided into 4 periods. The first stage covers the first week after the injury. Do not spend more than 10 minutes, use mainly respiratory and general strengthening exercises in a lightweight mode:
- Diaphragmatic breathing
- Rotational movements with hands and feet
- Compression of fingers and toes
- Flexion of the legs in the knees without stopping the foot from the bed
- Drawing alternately legs to the sidewithout breaking from the surface of the bed
The second period includes the first month of rehabilitation. The main task of this stage is to strengthen the muscular corset. The load and the number of repetitions gradually increases, the duration of training increases to one-third of the hour. The following exercises can be used in the recumbent position:
- Hand-to-hand ridge
- Elbow bending and pulling the wrists to the shoulders
- Isometric strain of the hip muscles
- Simulating the bicycle ride
- Lifting the legs in turns by 45 degrees.
In the third period, which lasts up to 2 months after the injury, we use exercises with weights and resistance, exercises in the position of kneeling. Duration and intensity of employment increases. Examples of exercises:
- Direction of straight legs using a rubber band
- Head and shoulder lifts in the supine position
- Moving on all fours in different directions
- Slight bends of the body from the kneeling position and resting on the back of the bed.
The fourth period continues from the moment of permission to get out of bed until the moment of discharge. As the adaptation to the spine is a complete axial load, the program includes movements in the standing position, exercises at the gymnastic wall.
- Standing with support on the back of the bed to roll from the toe to the heel.
- Bend the legs in turn in the hip joint and knee at an angle of 90 degrees.
- Standing and resting on the back of the bed with resistance pulling the leg to the side or back
- Perform light half-squats on the toes.
LFK - the main method of rehabilitation of patients with spine fractures. In addition to the main goal of therapeutic exercise is the prevention of pressure sores, the formation of blood clots and disorders in digestion, prevents dysfunction of the pelvic organs.