vertebral burst fracture
Introduction
Introduction to vertebral burst fracture Vertebral burst fractures, also known as vertical compression fractures, are less common and are mostly unstable. Because the fracture piece of this type of fracture is easy to invade the spinal canal, the incidence of paraplegia is high and should be noted. In addition to general first aid and treatment, it should be treated according to the following injuries. Because it is an unstable fracture, the back column is also susceptible to simultaneous damage in the case of damage to the front and middle columns. Therefore, the previous understanding of the fixed integration through the posterior road has been challenged. Because posterior surgery is difficult to obtain effective decompression and fixation, it is easy to make the treatment fail, and additional surgery is needed. basic knowledge The proportion of illness: 0.00035% Susceptible people: no specific population Mode of infection: non-infectious Complications: craniocerebral injury spinal cord injury
Cause
Causes of vertebral burst fractures
Causes
Violence factor (80%):
Mostly caused by vertical vertical compression violence. Human beings have long plundered the necessities of life from the natural world in order to survive. In the period of social development, the oppressed class usually uses violent means to overthrow the ruling class. Under the long-term oppression, the oppressed class is at a disadvantage in terms of economy and culture, but the number is large, so violence has become a weapon to promote social progress.
Pathogenesis
It is caused by longitudinal vertical compression violence, so it occurs mostly at the construction site and tunnel operation, and occurs in the neck 5,6 vertebral body, followed by the neck 4,7 vertebral body. At this time, the posterior longitudinal ligament is damaged at the same time, resulting in fracture The film often protrudes into the spinal canal and injured the spinal cord or spinal nerve root, accompanied by strong flexion, and the damage is more serious. In some cases, the vertebral arch is involved at the same time and shows comminuted fracture, due to the anterior, middle and posterior Loss of continuity and significant vertebral instability.
1. Front column involvement: vertebral body fracture, fiber ring fiber and anterior longitudinal ligament rupture.
2. Missing middle column: posterior vertebral fracture, posterior annulus fibrosus rupture and posterior longitudinal ligament rupture.
3. Posterior column rupture: bilateral fracture of the posterior structure.
Prevention
Prevention of vertebral burst fracture
Prevention of trauma, the elderly, especially those with osteoporosis, should pay attention to activities, avoid excessive damage caused by excessive force, and avoid falls.
Pay more attention to your diet:
1, should eat more vegetables containing more cellulose, eat some bananas, honey and other foods that promote gastrointestinal digestion and defecation.
2, avoid blindly add calcium: 1 avoid difficult to digest food. 2 avoid eating more meat and stewing bones.
Complication
Complications of vertebral burst fracture Complications, brain injury, spinal cord injury
It is easy to cause spinal cord injury and cyanosis, the incidence rate is as high as 70% to 90%, and can also be complicated by craniocerebral injury.
Symptom
Vertebral burst fracture symptoms Common symptoms Compression fracture spinal cord compression
In addition to the symptoms of general cervical spine trauma, the main features are as follows:
1. The injury is heavier: Because the violence causing this injury is heavier and directly affects the top of the head, the cervical vertebrae are severely affected, and it is easy to have a head injury, and attention should be paid to the atlantoaxial joint with or without injury.
2. The incidence of sputum is high: the broken bone piece is easy to displace in the direction of the empty spinal canal and cause spinal cord injury. Therefore, the incidence of sputum is about 70%, and sometimes it can be as high as 90% or more.
3. Symptoms of the neck and upper limbs are obvious: the small joints behind the vertebral body burst are also displaced, resulting in severe instability of the cervical vertebrae, resulting in local symptoms of the upper limbs and cervical vertebrae due to compression or stimulation of the spinal nerve roots. And is heavier than the general damage.
Examine
Examination of vertebral burst fractures
1. History of trauma:
Caused by vertical vertical violence.
2. Clinical manifestations:
As mentioned earlier, the injury is generally heavier and should be thoroughly examined.
3. Other inspections:
In addition to conventional positive, lateral X-ray film can show fracture and fracture piece displacement, body slice, CT or MRI is more conducive to the extent of injury, fracture type, direction and extent of fracture piece displacement and the impact on the spinal cord Such as the determination, individual cases may be MRI examination to determine the state of the vertebral artery.
Diagnosis
Diagnosis and diagnosis of vertebral burst fracture
diagnosis:
According to the X-ray positive position and lateral position, the diagnosis can be confirmed. On the conventional X-ray film, the spinous process gap can be wedge-shaped widened, the vertebral body also has a wedge shape, and there can be a triangular bone block under the vertebral body, wherein the wedge shape Patients with severe symptoms are often accompanied by different degrees of spinal cord symptoms. MRI or CT examination should be used for such cases, and myelography should be used for advanced cases (not suitable for early post-injury, but CTM can be used as appropriate).
Differential diagnosis:
Generally not confused with other diseases.
