Spinal compression fracture refers to a disease in which the vertebral body collapses and compresses under external force, presenting a wedge-shaped deformation state, resulting in symptoms such as lower back pain and discomfort. It is one of the common spinal injuries among the elderly. Some people say that a compression fracture is like a Mantou being flattened, but the overall shape is still maintained. At most, there are several cracks on the edge of the Mantou, but it is not so fragmented. If the whole is fragmented, it is called a comminuted fracture.
Why do spinal compression fractures occur?
Compression fractures of the spine in elderly people are generally caused by osteoporosis. Turning around, coughing, bending over, etc. can all lead to fractures, which are more common in the chest and lumbar spine, and are more common in elderly women. Spinal compression fractures may not be immediately detected after they occur, often tormenting you for a long time before they are taken seriously. The human spine is mainly composed of trabecular bones, which crisscross to form vertebral bodies. If osteoporosis occurs, the horizontal bone trabeculae will gradually decrease and disappear, while the vertical bone trabeculae will become thinner and sparser. When loose bones cannot withstand external pressure, fractures occur, also known as "compression fractures", because these external forces are usually not significant and some patients may not feel them.
The thoracolumbar junction is where bone stress is concentrated, so compression fractures often occur in the lower thoracic and upper lumbar segments. Patients often experience lower back pain due to falls and other triggers, and are afraid to move, which can hinder standing and walking. If the compression is severe, there may be damage to the spinous process or ligaments of the posterior column, resulting in local kyphosis or swelling and bruising. Tenderness and percussion pain are common, with restricted movement of the thoracolumbar spine. Most thoracolumbar compression fractures are stable fractures, with few cases of spinal cord injury paralysis.
How to treat spinal compression fractures?
Doctors usually first inquire about the patient's medical history in detail, understand the process of injury and the characteristics and changes of symptoms, and then conduct some physical examinations by hand or with simple tools to understand the location and nature of pain. Then, they use imaging (X-ray, CT, MRI) indicators to confirm whether there is compression fracture.
Different treatment methods are adopted based on the patient's general condition, symptoms, signs, and imaging examinations. The commonly used treatments are divided into two categories: conservative treatment and surgical treatment.
1. Conservative treatment
Elderly people generally choose conservative treatment. Because the body's tolerance deteriorates with age, it is difficult to place surgical consumables such as steel plates and screws on the affected area through open surgery, and the stimulation of surgical consumables can worsen osteoporosis. Therefore, conservative treatment is the only option. In addition, a significant reduction in activity during bed rest can further exacerbate osteoporosis, forming a vicious cycle. Conservative treatment is divided into the following categories -
Medication treatment: Painkillers can be taken according to medical advice.
Physical factor therapy, such as electrotherapy.
Exercise therapy: Elderly people can choose different rehabilitation training methods to improve their physical function based on their own physical condition and underlying diseases.
2. Surgical treatment
Generally, "bone cement" minimally invasive surgery is used: under the perspective of modern imaging equipment, a specially made fine needle is injected into the diseased vertebral body to support the collapsed vertebral body and enhance its stability, which is equivalent to rebuilding a "wall" supporting the vertebral body for the patient, in order to reduce or even relieve the patient's pain.
What are the precautions for protecting the spine?
(1) Some people often watch TV, play mahjong, or play cards for long periods of time. In this situation where they bend down and maintain a sitting position for a long time, the lower back muscles are always in a stretched state, and sterile inflammation occurs in the muscle fascia tissue, which stimulates the nerve endings in that area and leads to lower back pain. Sitting for a long time can also easily damage the lumbar intervertebral disc.
(2) Unreasonable sleeping bed and sleeping posture are also closely related to lower back pain. Sleeping on a thick mattress is most in line with the physiological state of the human body.
(3) It is necessary to train both the waist and back muscles as well as the abdominal muscles. Persisting in doing back and waist muscle function exercises is an effective measure for the prevention and rehabilitation of lower back and leg pain. There are two methods for exercising the waist and back muscles (patients who have already suffered from lumbar compression fractures should undergo rehabilitation training under the advice of a doctor):
The first method is to lie flat on the bed, bend both knees, place your feet on the bed, and then lift your hips with force, about 10 centimeters away from the bed surface. Persist in letting go for 3-5 seconds, repeat this 10 times a day, and do it 3 times a day.
The second type is commonly known as "Yanfei". Lying prone on the bed, with both upper limbs extended and placed on either side of the body, lift the upper body vigorously by about 10 centimeters. Similarly, persist in letting go for 3-5 seconds and repeat this process 10 times a day.
(4) Pay attention to keeping your waist warm in winter.
Spinal compression fractures usually cause great pain to patients, and paying attention to them can be avoided to a certain extent. I hope everyone can stay healthy.