How to treat lumbar vertebral compression fractures

A common cause of lumbar vertebral compression fractures is indirect violence, such as falling from a height. If this happens, you must stay in bed and rest. Drug treatment is very effective. If it is a serious spinal cord injury, surgery is required as soon as possible.

1. Syndrome Differentiation and Treatment

1. Stable fracture: Generally, patients need to lie on a hard bed for 6 to 8 weeks. People with compression fractures can use pillow therapy, and the appropriate height of the pillow is about 8 to 10 cm. This type of fracture is more effectively treated with qigong therapy, because correct and appropriate qigong therapy can not only restore the compressed vertebrae and maintain the stability of the spine, but also increase the strength of the back muscles due to early activities, thus preventing or aggravating osteoporosis and avoiding or alleviating the subsequent chronic low back pain. The specific steps are as follows:

A. Five-point support method: The patient lies on his back on a wooden bed, using the head, elbows and heels to support the whole body, and stretching the back as far as possible. This method can be used in the early stage.

B. Three-point support method: Developed on the basis of the five-point support method, the patient places his arms in front of the chest and uses his head and feet to support and exert force to lift the whole body into the air and stretch backward. This method can be used in the middle and late stages.

C. Flying Swallow Pointing Water Method: Also known as the "One-Point Method", the patient lies prone with the upper limbs extended backward, a pillow placed between the calves and ankles, the head and shoulders tilted back as far as possible, and at the same time the lower limbs are stretched back as straight as possible, the whole body is tilted up, leaving only the abdomen on the bed, forming an arc shape, commonly known as "two-end tilt". This method has higher requirements and is usually used after practicing the first two methods for a period of time.

2. Unstable fractures: If there are no clinical symptoms of spinal nerve injury, conservative treatment methods can also be considered, but the time for exercise activities should be slightly delayed and the bed rest time should be slightly longer. For patients with signs of spinal cord injury, surgical treatment should be considered.

3. Complete spinal cord injury: Perform surgery as soon as possible (preferably within 8 hours), perform open reduction, complete decompression, and internal fixation; and preferably start using adequate amounts of glucocorticoids (methylprednisolone) within 1 hour after injury and maintain for 1 to 3 days to minimize spinal cord injury.

4. Incomplete spinal cord injury: In addition to drug treatment and immobilization, clinical symptoms and signs should be closely observed. If there is aggravation or no obvious improvement, or if CT or MRI examinations show large bone fragments protruding into the spinal canal, and the spinal cord and nerve roots are obviously compressed, surgery should be performed as soon as possible; if the condition gradually improves, conservative treatment can continue. For patients with combined spinal nerve root injury, the treatment of incomplete spinal cord injury can be referred to.

2. Causes of Disease

1. Indirect violence:

The most common. It is more common when falling from a height, with the hips or feet landing on the ground, and the force is transmitted upward to the waist; or heavy objects fall from a height and impact the head, shoulders, and back, and the force is transmitted downward to the waist, causing fractures; some elderly people have severe osteoporosis, and certain minor injuries, such as bumpy rides in a car, sitting down on the ground, etc., can also cause vertebral fractures.

2. Muscle pulling:

When the muscles in the lumbar sacral region suddenly and strongly contract, considerable tensile stress can be generated, which commonly causes fractures of the vertebral appendages, such as the transverse process and spinous process. Severe muscle contractions caused by tetanus or other nervous system diseases can lead to compression fractures of the thoracic and lumbar vertebrae.

3. Direct violence:

Rarely seen. It can be seen in traffic accidents, firearm injuries, or direct blows to the waist. Such injuries often cause spinal cord injuries and have serious consequences such as varying degrees of paralysis.