Fracture of the spine can be of different types: fracture from compression, so-called. compression fracture (isolated fractures of vertebral bodies), fracture with displacement. In the latter case, we mean the displacement of the spine as a whole. Such a fracture with a displacement is sometimes called a dislocation, or a luxury fracture. In this article, we will talk about the fracture of the spine with displacement.
Displacement with a fracture of the spine happens with significant force. In this case oblique or complete transverse fracture of the vertebral body, dislocation and subluxation of the lateral intervertebral joint, rupture of the ligamentous apparatus, as well as fracture of the arches and spinous processes. With a shifted fracture, the spinal column, lying higher, shifts downward and forward, that is, as it advances towards the underlying one, sometimes even before it. In this case, the underlying spine, respectively, shifts up and behind, going into the spinal canal with its posterior edge and damaging (squeezing) the spinal cord. The spinal cord is damaged in different ways: damage can leave no visible traces, and small hemorrhages can gradually resolve, in other cases, a complete transverse rupture of the spinal cord may occur.
Symptomatic for a fracture with a displacement of
The clinical picture consists of pain syndrome, functional disorders in case of damage to the spinal cord and deformation of the spinal column. Localized pain in the fracture region is not so characteristic, since pain is inherent in bruises and sprains. A more indicative symptom is the deformation of the vertebral column itself. With fractures with displacement, the deformation is strong enough and manifests itself in different forms. Displacement can be detected through the covers of the peritoneum and on the back wall of the pharynx.
In the area of the fracture itself, development of the reflex contracture of the long dorsal muscles with restriction and weakening of the spinal motion is sometimes observed. Very rarely in the area of fracture there is abnormal mobility. Fracture of the spine may be accompanied by the phenomenon of paralytic obstruction, swelling of the intestine.
From the side of the spinal cord there may be various symptoms, depending on the nature of the damage and the level of fracture. In the first ten to fifteen days after the injury, the degree of damage to the spinal cord can be established only approximately, because these days there may be unexpected improvement and complete disappearance of paralysis. In this case, care must be taken in forecasting and recognition.
Treatment and diagnosis
Sometimes a fracture of the spine is not established, because either symptoms are not sufficiently expressed, or the doctor distracts to the initial shock of the patient. Therefore, with the slightest suspicion of a fracture of the spine, radiography is necessary, and in two projections - a side shot and from the front to back.
A fracture with a displacement often results in a lethal outcome of . In surviving bone fusion may occur 3-4 months later. The consequences of such a fracture - ankylosis, persistent curvature of the spine and other dangerous complications. To prevent complications, rinsing of the bladder with a solution of boric acid, streptocid, urotropin, antibiotics is prescribed.