Vertebral fracture
| Classification according to ICD-10 | |
|---|---|
| S12 | Fracture in the neck area |
| S22 | Fracture of the rib (s), sternum, and thoracic spine |
| S32 | Fracture of the lumbar spine and pelvis |
| ICD-10 online (WHO version 2019) | |
A vertebral fracture , also known as a vertebral fracture , is a fracture of a vertebra in the spine .
Forms and frequency
Most often it is a vertebral fracture , i.e. a fracture of the vertebral body. A vertebral fracture can also affect the vertebral arch , a transverse process, or the spinous process. The spinal canal can also be indirectly affected, be it through an injury from bone fragments or through a displacement of the spine. There is a risk of a paraplegic syndrome .
If the bone structure is stable, one or more vertebrae can break as a result of violence, such as traffic accidents, falls or physical violence. The healthy bones of the vertebra burst through compression or direct force. In contrast, there is an osteoporotic vertebral fracture in the elderly: the osteoporotic bone crumbles rather than breaks. As a result of bone loss, the vertebra becomes porous and loses its stability. These breaks can be triggered by lifting a shopping bag or blowing your nose.
Every year almost 230,000 people between the ages of 50 and 79 in Germany suffer a fractured vertebra. Vertebral fractures make up about two percent of all fractures.
Symptoms
Stable fractures in particular can be symptom-free. Immediate back pain is one of the most common symptoms, as well as restricted mobility or even paraplegia. However, unnatural reflexes, sensory disturbances or symptoms of paralysis can also occur.
Diagnosis
A physical exam is performed to diagnose the condition, which also tests nerve functions. CT images show the vertebrae and help assess the fracture situation. If there is any suspicion of involvement of the spinal cord, an MRI scan is arranged. This also makes it easier to assess bleeding.
classification
There are several classifications for assessing vertebral fractures. In the current Magerl classification, vertebral fractures are divided into type A, type B and type C injuries. The type A injuries are compression injuries. Only the ventral column of the spine is affected, whereby the type A injury can be further subdivided into impaction fractures (A1), cleft fractures (A2) and burst fractures (A3). A type B injury is called a distraction injury to the vertebral body. These injuries are unstable to flexion, extension, and sometimes rotation. A distinction is also made between flexion and extension injuries with or without dislocation to the front or back. The type C injury was caused by rotational movements. Here, types A and B are combined with the C violation, in that the C1 violation represents a type A violation with rotation. The same with the type B injury in type C2. The type C3 fracture is a rotational shear fracture and is usually extremely unstable.
treatment
A vertebral fracture can be treated surgically or conservatively. Unstable fractures, the internal organs or spinal cord injury or compress the spinal cord, must of the spine, usually by means of a stabilization kyphoplasty or spinal fusion are operated. Stable fractures and fractures in the elderly can often be treated conservatively. The focus here is on eliminating pain. Physiotherapeutic treatments are intended to mobilize the patient, improve posture and enable movement that is easy on the back. Sometimes external supports in the form of support corsets or bodices are needed.
Individual evidence
- ↑ Initiative “Right now! It all depends on the vortex. ” ( Memento from August 2, 2012 in the web archive archive.today ). Retrieved April 25, 2010.
- ↑ a b c How is the spine built up? in the medical dictionary of the Techniker Krankenkasse.
- ↑ Vertebral body fracture (vertebral body fracture): diagnosis. in the Onmeda Lexicon.
- ↑ B. Weigel, M. Nerlich: Praxisbuch Unfallchirurgie. Volume 1, Springer Verlag, 2005, ISBN 3-540-41115-1 .
- ^ Website of the trauma surgery department of the University Hospital Gießen and Marburg .
