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Crush Fracture – Treatment, Symptoms, Causes for Vertebral and Other Crush Fractures

9 Aug

Crush fractures, also called compression fractures, are caused by the compressive force which can crush, wedge or burst the vertebrae. As a result, pain can be felt by the person once the fracture will the spinal cord or the nerve roots become compressed. This kind of fracture is most often caused by osteoporosis. A person becomes more exposed to it with time. Being that humans are upright, weak bones of the back would cause them to crumple when gravity prevails over them.

Affected Area

Crush fracture initially starts affecting the T12 vertebrae and as the fracture progresses, it would also touch T8 through to L3. The pain that the person will feel does not only remain in the back portion of the body. It can also be felt all over the body. For instance, if the T9 vertebrae is crushed, this will cause the person to feel pain in the anteriorly rib margin and in the back. A crush fracture involving L3 would course pain in the thighs and knees.

Crush Fracture Causes

Osteoporosis is one of the most common causes of crush fracture. If this is the case, the usually affected areas would consist of the vertebrae in the chest or the lower back. It may also be caused by a traumatic injury such as falling or even the simple act of bending. The risk associated with a thoracic crush fracture is that the person might eventually become a hunchback and extreme pain might also be constantly experienced. Another cause would also be possible tumors that have affected the bones in the back.

Crush Fracture Symptoms

At first, a person with crush fractures would only feel small hints of pain in the back when a vertebra is already sustaining minor trauma. If more vertebrae are affected, this will become visible in the fact that the person may already have an extreme curve of the neck and suffer from dorsal     hyperlordosis or a slightly rounded back. As more areas become affected, the pain will become even more severe with an experience of acute pain that will last for days. This will become a dull chronic pain in the mid and lower back. In severe cases, a person may even go to shock or keep on vomiting. These bouts of pains can be cured temporarily by bed rest for three weeks.

However, pain may come back when more vertebrae are crushed. Constant pain that can be felt by the person suffering from crush fractures may be brought about by the compression of the veins which are coursed through the vertebral foramina. This can result to fibrosis and even congestion of nerve roots. Crush fracture may also be signified by loss of as much as six inches in height which is already a big and visible drop.

Diagnosis

As crush fracture is related to spinal injury, this can be diagnosed using x-rays or a CAT scan. An MRI is also considered in order to evaluate the damage done by the compression on soft tissues. It can also be used to assess if there is bleeding or some ligament disruption. Aside from using these machines, the doctor will also need to do a physical examination. This is to evaluate the spinal deformity and the level of tenderness felt around the fractured area. Another round of test would consist of a neurologic exam. This series of tests would include testing bowel and bladder sphincter control, sensation and reflexes of the lower extremities, and muscle strength.  Rehabilitation or rehab is required.

Crush Fracture Treatment

Basic treatment would include a back brace and pain medication as well. Drugs though are rarely recommended by some doctors for there is the risk of further weakening the already crushing bones. There are also some other options to cure crush fractures.

• Physical therapy can also help by strengthening the muscles around the spine. This can be done with bed rest and some medication for two months. If these do not have positive results still, there are other minimally invasive treatment options available.

• Crush fractures that are brought about by suffering from osteoporosis may also be corrected by immobilizing the cervical spine with a Philadelphia collar or some other cervical orthotic.

• Balloon kyphoplasty would require inserting a balloon into the vertebra using needles. Once the balloon is already inflated inside, this will help restore the original bearing and height of the vertebra. To make this even more permanent, cement is injected into the vertebra too. This procedure for vertebral crush fracture needs general anesthesia.

• Vertebroplasty is also one of the treatment options to correct some cases of crush fracture vertebra. A glue-like material will be introduced into the center of the crushed vertebrae in order to give them some stability. The glue-like material which is called methylmethacrylate will be introduced into the vertebrae using a needle and a syringe. Anesthesia is needed for the portion of the skin where the injection will be done. The glue should hit the midportion of the vertebrae and this target can be hit by looking at specialized x-ray equipment. Once the glue in inside, it will eventually harden and form like a casting on the broken bones.

Crush Fracture Healing Time and Recovery Time: More than 8 weeks.

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