Consequences of the vertebral fracture | Vertebral fracture

Consequences of the vertebral fracture

The consequences of a vertebral fracture can be very different for those affected. They depend on the type of fracture, the cause and the general condition of the patient. Stable fractures can usually be treated conservatively, i.e. without surgical intervention.

These can also be very symptom-free. For example, the pain is either not present at all or only very slight. However, this does not have to be the case, since even stable fractures can cause severe pain.

The conservative therapy can last up to several weeks and includes physiotherapy, pain medication and supporting measures such as the application of a corset. Despite such measures, patients may experience pain that is refractory to therapy and, in the worst case, may become chronic. For patients with an unstable vertebral fracture, surgery is unavoidable.

Such an operation can result in a longer period of bed rest. In any case, the surgical wound must be protected so that the stability of the operated vertebra is not compromised. In the worst case, vertebral fractures can lead to paralysis or sensitive sensations or even numbness of a body part if the spinal cord or nerve roots are damaged. In the extreme case, paraplegia can result.Severe paralysis can be irreversible even with successful surgery if the damage to the spinal cord or nerves is too great.

Localization of the vertebral fracture

In most cases, the lower thoracic spine and upper lumbar spine (lumbar spine) are affected. In about 20% of cases more than one vertebral body is affected.

Classification

The classification of vertebral fracture: There are separate classifications of vertebral fracture for the first two cervical vertebrae (Atlas and Axis), which will not be mentioned here. The most important characteristic of vertebral body fractures is the classification into stable and unstable fractures. While stable vertebral fractures do not pose a threat to the spinal cord, unstable vertebral body fractures endanger the spinal cord with mobile fracture fragments (fractions).

The question of spinal stability after an injury is determined by the injury consequences of the posterior spinal structures: According to Magerl (1980), primarily stable spinal injuries (A) are as follows: Compression or compression of the vertebral cancellous bone with intact ligament and joint connections and, at best, slightly injured intervertebral disc. This usually results in the typical wedge vertebra. There is no injury to the posterior wall of the vertebral body.

Despite immediate loading and immediate mobilization, no increase in deformation and no fracture fragment displacement is to be expected. In contrast, at least two out of three stability elements (anterior vertebral body, posterior vertebral body, posterior spinal ligament complex) are injured in primary unstable spinal column injuries (B). There is a risk here of increasing deformation and fracture fragment displacement.

  • Posterior edge of vertebral body and disc wall
  • Vertebral arch and articular processes
  • Posterior spinal ligament complex