Jiang Ying, Huo Litao, Department of Spine Surgery, Characteristic Medical Center (formerly 306 Hospital).
Edited by Liu Yan/Cui Yan, Medical Science Popularization Center
Many elderly patients will find that they have a compression fracture of the thoracolumbar or lumbar spine during an outpatient radiograph, and they have no clear history of trauma.
Vertebral compression fracture refers to the fact that the spine has been flattened, the internal structure of the bone has been destroyed, and the original vertebral height has been compressed, which is a more common type of fracture in the vertebral fracture. Vertebral compression fractures are more common in older people, and some young people will develop vertebral compression fractures if they have severe trauma.
What causes a compression fracture of the spine?
(1) Osteoporosis or multiple myeloma and metastatic tumors of the vertebral body are all factors that cause vertebral compression fractures.
(2) Osteoporosis and other diseases will lead to a decrease in the quality and strength of human bones, and mild trauma can cause vertebral collapse of the spine, that is, spine compression fracture.
(3) For osteoporosis, slight waist twisting, car bumps, etc. in daily life will lead to compression fracture of the spine. After the fracture, there will be pain in the lower back, followed by soreness, numbness, and pain in the lower limbs.
How are compression fractures of the spine treated?
(1) Non-surgical treatment
(1) Patients with vertebral compression fracture should lie on a hard bed, which can not only reduce pain, but also facilitate the reduction of compressed vertebral body. When lying on the back, the injured part should be gradually raised with a small sandbag or soft pillow, so that the compressed vertebral body is gradually retracted, reduced, and restored to the original height, but the compressed height of the vertebral body of most patients is difficult to return to the normal height before the injury.
(2) After 1 week in bed, after the low back pain is relieved, the exercises should be actively strengthened to prevent the weakness of the low back muscles caused by long-term bed rest, and also help to promote the reduction of the compressed vertebral body. The method is to lie flat and raise the waist so that the waist is off the bed, and repeat. When exercising, you should do what you can, and those who are in poor health should reduce the intensity of exercise.
(3) Actively strengthen the treatment of osteoporosis, including intramuscular calcitonin, oral vitamin D, oral bisphosphonate preparation and other measures. After waking up and exercising, you should spend more time in the sun, strengthen exercise, and eat more foods with high calcium content.
(4) Some anti-inflammatory analgesics can be taken orally to relieve pain during bed rest. The time of lying on the hard bed is 6~8 weeks, and the X-ray examination confirms that the fracture has healed and gradually resumes walking.
(2) Surgical treatment
With the development of minimally invasive techniques, percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) have become safe and effective minimally invasive treatment techniques for the treatment of vertebral compression fractures. This surgery uses X-ray machine fluoroscopy as a guide, percutaneously inserts a special injection needle, and injects bone cement into the diseased vertebral body through the needle, so as to enhance the strength and stability of the vertebral body, prevent the vertebral body from continuing to collapse, and eliminate or reduce lower back pain.
In summary, the incidence of vertebral compression fracture in elderly osteoporosis patients is relatively high, and the rehabilitation cycle is long, so we need to correctly understand the vertebral compression fracture, understand the causes and treatment methods of vertebral compression fracture, and actively take preventive measures in daily life to reduce the probability of vertebral compression fracture. If you find that you have a compression fracture of the vertebrae, you should go to the hospital for treatment in time, and do a good job of rehabilitation training after surgery to reduce the occurrence of postoperative complications.
(The picture comes from the Internet)