Thoracolumbar vertebral compression fracture

Introduction The thoracic and lumbar vertebrae junction is the place where the bone is concentrated. Therefore, the fracture often occurs in the thoracic 11 and 12 lumbar 1, 2 vertebral bodies, which is called the thoracolumbar fracture. Middle-aged and elderly vertebral osteoporosis, under the action of mild external force can cause vertebral compression fracture.

Cause

Predisposing factors for thoracolumbar vertebral compression fracture

The common cause of fracture is sudden bumping when riding a car, causing compression of the vertebral body under the action of its own gravity; slipping when walking, causing a fracture on the buttocks; or sitting on the ground and causing a fracture. After compression, the vertebral body becomes flat and forms a wedge shape with a narrow front and a wide back. The heavier the injury, the more obvious the degree of vertebral compression.

an examination

Related inspection

CT examination of bone and joint and soft tissue for cremaster reflex

Sudden pain in the lower back after injury, palpation along the spine, localized tenderness and snoring pain in the thoracolumbar region, and compression fractures should be considered when the spine has kyphosis. X-ray film can be seen that the injured vertebral body is wedge-shaped, and the degree of compression of the vertebral body is generally 1/4 to 1/2.

This type of fracture is generally stable and the vast majority can be cured without surgery. In the middle-aged and elderly people, compression fractures rarely affect the nerve function except for low back pain. The lower limbs can move, so that after the injury, the patient can be considered nothing, which may cause misdiagnosis or missed diagnosis and affect treatment. Therefore, if the middle-aged and elderly people have pain in the lower back after injury, they should go to the hospital for examination even if they are not heavy, so as not to delay the treatment. Also, pay attention to whether or not to incorporate other damage.

Differential diagnosis

Symptoms of complication of thoracolumbar vertebral compression fractures:

1 stable fracture: any simple vertebral compression fracture (the anterior compression of the vertebral body does not exceed 1/2 of the thickness of the vertebral body, without attachment fracture or ligament tear); or simple attachment (transverse process, spinous process or unilateral vertebra) Plate and pedicle fractures are stable fractures. Such fractures have little effect on the stability of the spine. Generally, there is no ligament injury, no obvious tendency to shift, and it is simple in treatment. The conservative treatment is used, and the prognosis is good.

2 unstable fractures: Where the vertebral body compression exceeds the thickness of the vertebral body l/2, comminuted, or fracture with dislocation, accessory fracture or ligament tear is an unstable fracture. These types of fractures are caused by intense violence, the stability of the spine is destroyed, and more ligament tears and spinal cord or spinal nerve root damage are difficult to treat. Most of them require surgery and the prognosis is poor.

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