Compression fracture of the 7th vertebra in children. What it is? Injury factors

A spinal fracture in children is an injury that violates the anatomical integrity of the spinal column, accompanied by pain localized in the damaged area, and spinal deformity at the fracture site. In addition, there is swelling of soft tissues, as well as a violation normal operation limbs and pelvic organs of the child. A spinal fracture is diagnosed using X-ray, MRI and CT. Treatment of a spinal fracture in children is carried out in stages, which include: traction, exercise therapy, massage, physiotherapy, breathing exercises, wearing a corset to stabilize the spine, and in case of serious violations, surgical intervention is possible.

Spinal fractures in children are often accompanied by other injuries, such as craniocerebral injuries. thoracic, pelvis and limbs. The causes of spinal fractures in children are different. A fall from a tree or a swing, a sharp bending of the spine during somersaults or wrestling, an accident and a number of others can lead to a fracture of the spinal column. external causes. In addition, in children, a spinal fracture can be the result of diseases such as osteoporosis and osteomyelitis, which lead to a fracture with minimal physical exertion, as well as various birth injuries.

Experts note that the number of simple and compression fractures of the spine over the past decade has increased by six percent. Traumatologists explain this trend by the increase in the activity of modern children, the increase in the number of accidents, as well as the development of diagnostic methods that make it possible to determine the injury in the most difficult cases. The most common fracture of the vertebrae occurs in children and adolescents from 10 to 15 years.

Compression fracture the spine in children is considered quite serious damage, which can be received even with a small sharp blow, say when jumping, diving or falling, followed by a landing on the buttocks. The cause of compression damage to the spine can be a lack of calcium in the child's body, which occurs with osteoporosis. It should be noted that an uncomplicated form of a compression fracture often cannot be diagnosed, since there are practically no symptoms of damage to the spinal column, and its functions do not change. Parents of children who have received such a spinal injury often believe that it will hurt and stop, but the consequences of this can be very serious.

The concept of "compression" means compression, it follows that such a fracture in a child is the result of compression of the spinal column, in which the vertebrae are flattened, deformed and cracked. Most often, the lower and middle parts of the thoracic region and the lower back are affected. The fact is that when falling from a height on the buttocks or a sharp somersault, the spinal column is forced to bend in an arc, which leads to a sharp contraction of the back muscles, and significantly increases the pressure on the anterior spine. However, the middle region of the thoracic region experiences the greatest load. As a result of exceeding the limit of physiological flexibility of the spinal column, wedge-shaped compression occurs, and as a result, a compression fracture occurs.

Compression fracture can be divided into three levels of complexity, depending on the magnitude of the deformity of the vertebral body. With damage to the spinal column of the 1st degree, the decrease in the height of the vertebral body does not exceed 1/3, with the 2nd degree of deformation, 1/2 of the vertebral body is deformed, and with the 3rd degree - more than half.

As a rule, injuries of the 1st degree are considered stable, and the rest are unstable, the hallmark of which is the pathological mobility of the vertebrae. Injuries can be both single and multiple, but in any case, they are most often localized in the region of the middle thoracic region.

Characteristic features of a spinal fracture

For minor vertebral injury, put correct diagnosis very difficult, because bright severe symptoms practically absent. However, carefully conducted palpation and tapping help in determining the most painful point located in the area of damaged vertebrae. Gentle pressure on the head and shoulder girdle will also help identify signs of damage to the spinal column - pain at the site of the injured vertebrae. In addition, some caution is noted in the movements of children with spinal fractures.

Typical symptoms of a compression fracture of the thoracic region:

difficulty breathing at the time of injury
slight soreness and tension of the spinal muscles in the area of damage
pain when loading the axis of the spine

Injuries to the vertebrae often cause radiating pain in the abdomen. Signs of paralysis of the limbs and disruption of the normal functioning of the pelvic organs are rare, only after damage to the thoracic region with displacement of the vertebrae or spondylolisthesis.

With a compression lesion of the middle thoracic region in children, the most common complaint is difficulty in breathing, sometimes turning into a short-term delay. In the case of an injury to the cervical vertebrae, there is a characteristic head position and limitation of its movements and inclinations, as well as tension in the neck muscles. Approximately every third compression fracture of the spinal column is accompanied by irritation of the nerve roots. spinal cord and its shells.

In some cases, compression of several vertebrae simulates symptoms acute abdomen, and leads to diagnostic errors.

How are compression fractures treated in children?

The treatment of a compression fracture consists in the early and complete release of the spinal column from the load, which is achieved by traction. If the vertebrae of the upper thoracic region and neck are damaged, the Glisson loop is used, and for injuries below the fourteenth vertebra of the thoracic region, treatment is carried out using straps passed behind the armpits and a reclinator. It is advisable to wear a corset in case of a fracture of more than three vertebrae, especially if the vertebrae of the lower thoracic region and the lower back were injured in children, as well as in difficult cases. Dispensary observation can take from one and a half to two years - the time it takes to fully restore the height of the injured vertebral body. In addition, the role of massage and exercise therapy in the treatment of such injuries should not be underestimated.

Treatment of such injuries in children as a compression fracture can be divided into three stages.

The first, lasting up to five days, involves blocking pain and unloading the spinal column. At this time, the baby is shown the strictest bed rest on a solid base with a thirty-degree slope.
Treatment at the second stage, lasting up to two weeks, consists in restoring blood flow in the affected area, and courses of electrophoresis and magnetotherapy. During this period, bed rest is also indicated for the child.
At the third ten-day stage, a muscular corset is formed. In addition to bed rest for traction and physiotherapy, back massage is added at this stage. Exercise therapy is used in all three stages.

Exercise therapy and massage are an integral part of the treatment of spinal fractures and subsequent rehabilitation

In the first week after vertebral injury, treatment includes exercise therapy exercises aimed at improving performance respiratory organs, hearts and gastrointestinal tract. Along with this, a complex of exercise therapy is carried out, which prevents a decrease in muscle strength.
In the next two months, the goal of exercise therapy is to strengthen muscle corset and preparation for future physical activity. At this time, additional exercises are introduced into the complex of physiotherapy exercises that increase the load on the body of an injured child. In addition, the time of classes should be made longer by increasing the number of exercises.
Rehabilitation at the next stage is characterized by preparation for vertical loads, for which exercise therapy exercises with weights and resistance are performed. The final stage of therapeutic exercises is performing exercises while standing, or direct vertical loads. The terms of the last two periods of exercise therapy are determined on an individual basis.
Rehabilitation after any damage to the spinal column cannot do without massage, which, like exercise therapy, is part of conservative treatment.

Therapy and subsequent rehabilitation of children who have received a fracture of the spine, using therapeutic exercises and massage, contributes to the independent restoration of injured tissues. For example, a kneading massage is indispensable after a compression injury to the vertebrae, which, along with muscle strengthening, prevents the occurrence of bedsores in children who have been in bed for a long time.

Parents of babies who have received injuries of the spinal column should know that today's development of medicine contributes to the successful solution of this problem, and classes therapeutic gymnastics and massage, can reduce to almost zero the effects of injury.

Possible consequences of fractures

Full recovery of a child after spinal injury will require a long time and great parental patience. Bed rest, regular exercise, massage, and following all doctor's orders are requirements that are not so easy to achieve in children. The most favorable prognosis concerns vertebral injuries of the 1st degree, which in most cases result in a complete recovery.

Sometimes the consequences of injuries are expressed in such diseases as post-traumatic kyphosis and osteochondrosis, spondylitis and others. Babies after injuries of the spinal column are observed in the dispensary for two years. Untimely access to a doctor can cause future disability due to complications, such as kyphoscoliosis or vertebral necrosis.

General prevention of childhood injuries contributes significantly to the prevention various forms spinal fracture. Key role in implementation preventive measures assigned to parents or teachers who are responsible for organizing safe conditions for children's leisure. In addition, adults should often carry out explanatory and preventive work among children.

Children are active due to their age, but this has reverse side- pranks end with injuries and damage. The body of the child is still being formed, therefore it is vulnerable to influences. A bad fall can lead to a compression fracture of the spine. How to identify the problem and help the child?

What is a compression fracture of the spine?

Compression fracture - damage to the vertebra as a result of strong compression. Sometimes the deformation is represented not only by the formation of cracks in the spinal disc, but also by a violation of the integrity of the surrounding tissues due to severe destruction and fragments.

According to statistics, the lower thoracic and middle thoracic spine are more often affected. The greatest threat is damage to the cervical vertebrae, as there is a risk of injury to the spinal cord.

Types and degrees

There are 2 types of compression fracture of the spine:

uncomplicated - proceeds secretly, the patient has only pain at the site of injury;
complicated - there is not only pain, but also other symptoms: a decrease or loss of sensitivity, numbness occurs. Broken bones can hurt nerve roots.

Depending on the degree of destruction of the vertebra, the following types are distinguished:

mild - reduction of the vertebra by 30% or more;
moderate - deformation by 50%;
severe - a decrease in the length of the vertebra by 50% or more.

Causes and risk factors

A compression fracture is caused by trauma or heavy stress. The child may fall and get hit - with the weakness of the spinal column, this ends with damage.

Factors predisposing to fracture are:

- pathology is characterized by a deterioration in the structure and a decrease in bone density, which makes the spinal column weak. Diseases that negatively affect the spine of a child also include scoliosis and other disorders;
vitamin deficiency - a lack of nutrients affects the body, including bone tissues, which become sensitive to moderate and heavy loads;
injuries - not only a fall from a height leads to damage, a careless somersault in a physical education lesson or lifting weights ends with a compression fracture.

Damage symptoms

Detection of a fracture may be difficult due to latency of the injury or mild symptoms, as the child's vertebrae are more elastic than those of adults.

Application required for medical care if symptoms occur:

discomfort at the site of injury - the pain gradually decreases after the injury, but intensifies during movement;
hematomas;
deterioration in well-being, accompanied by weakness and nausea - indicates serious damage;
decrease in motor activity - restriction of movement is associated with painful sensations when trying to perform a certain action.

Depending on the location of the damage, additional symptoms occur:

chest injury or cervical- deterioration of head mobility;
lumbar - the appearance of pain of a pulling nature in the abdomen.

The following manifestations of a fracture are less common:

pressure reduction;
problems with defecation and urination.

Establishing diagnosis

Often, children are at the doctor's appointment too late, when the health of the little patient has deteriorated significantly. Therefore, it is important to pay attention to the complaints of the child and immediately seek medical help.

The traumatologist examines the victim, determines complaints and palpates to identify diseased areas. Such measures are not enough to obtain a complete picture of a compression fracture, therefore, they resort to the help of instrumental diagnostics:

Densitometry. The research method is aimed at studying bone density, which will help identify osteoporosis and other diseases.
CT scan. During the diagnosis, hemorrhages are detected and the structure of the bones is studied in detail.
Radiography. Carrying out the procedure in direct and lateral projections will allow you to detect a fracture and determine its location.
Magnetic resonance imaging. The procedure is used if you suspect a pinched or damaged nerve endings.

Differential diagnosis of compression fracture - table

Disease	Symptoms
Scoliosis	Curvature of the spinal column; different arrangement of the blades; shoulder asymmetry; head off center.
Spondylolisthesis	Weakness; reducing the distance between lower ribs and wings of the ilium; pain extending to the lower extremities; shortening of the body; deterioration in posture.
Discitis	Muscle weakness of varying degrees; muscle spasms; tingling; fever; chills; numbness; violation of the functioning of internal organs as a result of compression of nerve endings; violation of urination.
Congenital wedge-shaped vertebrae	Pain in the back, radiating during prolonged stay in sitting position and exercise in the lower back; fast fatiguability; shortness of breath - the volume of the lungs decreases; with cervical lesions.

Features of treatment

It is recommended to call ambulance with a suspected spinal fracture. If at mild degree the child complains of pain, and his mobility is unlimited, so take the patient to medical institution does not seem difficult, then in severe cases, complete rest is required. The task of parents is to calm the victim.

With an uncomplicated type of fracture, treatment is carried out in a hospital, after which the patient is restored under the supervision of a physician. Complicated cases require individual approach and placement of the child in a special center for rehabilitation.

Depending on the nature of the damage and the causes of the compression fracture, the following periods of treatment are distinguished:

25–30 days after the injury - the child is in the hospital and therapy is carried out;
30–60 days after the fracture - stay in a rehabilitation center to restore ligaments and damaged tissues;
3-10 months after injury - restoration of the functions of the spinal column
the period of residual changes (1 year after the fracture) - the completion of the recovery process.

conservative technique

During the treatment of a compression fracture, medications are used. The task of the funds is to eliminate discomfort and deficiency of nutrients. Painkillers are prescribed:

Adol;
Paracetamol;
Nurofen;
Analgin.

In order to eliminate the deficiency of minerals and strengthen the body, drugs are prescribed:

products with calcium: Complivit Calcium D3 and Calcium D3 Nycomed Forte;
vitamin complexes: Alphabet, Multi-Tabs;
immunostimulating and restorative: tinctures of ginseng and eleutherococcus, Immunal.

To reduce pain, bed rest is also shown, to which a number of requirements are imposed:

the surface of the bed must be hard;
the head is slightly raised.

Special orthopedic mattresses are most convenient in this situation, as they have a positive effect on the patient. To improve the degree of extension of the spinal column, gradually increase the angle of inclination.

Spinal traction is another treatment option after a fracture to reduce stress. Devices used:

in case of damage upper divisions- Glisson's loop, which stretches the spinal column under the influence of the weight of the patient;
in case of a fracture of the vertebrae located below the 14th - straps and reclinators.

Drug Gallery

Immunal - immunostimulating agent Complivit Calcium D3 compensates for the lack of calcium Eleutherococcus extract strengthens the body Ibuprofen - pain reliever

Exercise therapy and massage

Therapeutic gymnastics is included in the recovery period of the patient. The task of the method is to restore mobility and flexibility to the spine, as well as to prepare the body for movement after physical inactivity. Treatment takes place in several stages:

6-8 days - strengthening the body and reducing negative impact forced stay in lying position:
- diaphragmatic breathing;
- finger flexion;
- rotation of the feet or hands.
From 7–9 to 21–25 days - the formation of a muscular corset:
- abduction of hands to the sides;
- lifting legs alternately;
- stop flexion.
From 21–25 to 35–45 days - preparing the patient for transfer to a vertical position:
- flexion of the arms at the elbow joint;
- lifting legs at an acute angle;
- exercises on all fours;
- bending and straightening the legs.
From day 45 to discharge - transition to a vertical position:
- lifting both legs;
- slopes;
- bending the arms at the elbows with a slight weight;
- alternate abduction towards the legs;
- rolling from toe to heel in a standing position.

Massage is aimed at normalizing blood circulation. With a mild degree of damage, the procedure can be prescribed the next day after the child is admitted to the hospital, and in severe cases, only at the direction of the doctor, taking into account the patient's condition.

For massage it is not required to remove the corset or reclinator - the devices do not interfere with the procedure.

The duration of the event and the volume of actions increase as the child recovers - they start from 15 minutes, gradually increasing to 25-30 minutes. The initial elements are rubbing and stroking, then include squeezing and shaking. The massage session is carried out only by an experienced specialist.

Gymnastics with a compression fracture - video

Physiotherapy and swimming

Physiotherapy techniques normalize blood circulation and metabolism. The following treatments are used:

magnetotherapy;
ultrahigh frequency therapy;
applications with paraffin;
cryotherapy;
electrophoresis.

Swimming is shown to patients 1-1.5 months after the fracture, but exercises in the water in the early stages are not prohibited. Important condition- the patient must be correctly delivered to the pool and transported back. Depending on the duration of treatment and the severity of the injury, exercises in the water are used:

leg movements imitating breaststroke and crawl;
body tilts in different directions;
circular movements of the body;
crossing the lower limbs imitation of cycling.

The best spinal stretch is achieved during backstroke freestyle or breaststroke, but such activities are carried out with the permission of a doctor.

Surgical intervention

Surgical techniques are indicated for the treatment of moderate to moderate compression fractures. severe degree. In childhood, preference is given to minimally invasive interventions:

Vertebroplasty. Through a small incision, a special solution is introduced that prevents destruction. The technique allows you to save the patient from pain and strengthen the vertebra.
Kyphoplasty. Through several incisions, needles are inserted, with the help of which the deflated chambers are installed. They are inflated, which leads to the restoration of the normal shape of the vertebra. After the balloon is removed, the space is filled with a special compound.

In severe cases, open operations are performed, during which the affected vertebra is stabilized and connected to adjacent areas.

Nutrition Features

In addition to gymnastics and physiotherapy, it is mandatory to introduce proper nutrition. Preference is given to products that have a lot of calcium, magnesium and silicon in their composition. The diet includes:

blackcurrant;
seafood: crabs, shrimp, sardines;
beans and beans;
cauliflower;
nuts: almonds, hazelnuts;
boiled fish;
radishes and turnips;
grain and bran bread;
dairy products: cheeses, cottage cheese, sour cream;
green vegetables: spinach; parsley dill;
fruits: persimmon, dried apricots.

For the patient, tinctures of nettle and yarrow, as well as a decoction of wild rose, will be useful.

Foods rich in calcium and vitamins - gallery

Blackcurrant strengthens the body Cheese - pantry of calcium Spinach contains useful material and vitamins Almonds are rich in calcium

Predictions and Complications

damage to the nerve roots;
stenosis of the spinal canal (impaired blood supply);
curvature of the spinal column;
formation of instability in the affected vertebra;
osteochondrosis and other pathologies.

It is impossible to protect children from injury, so it is possible that you will have to face damage. varying degrees gravity. The task of parents is to be fully equipped and know how to behave in case of a compression fracture of the spine and what steps to take to preserve the health of the child.

The child's body is not strong enough. This also applies to the skeleton. The growth of bone tissue is still ongoing, they are more susceptible to damage than in an adult. But recovery of bones after injuries in children is faster (subject to proper treatment).

The spine is the main part of the musculoskeletal system. The vertebrae, which are one of its constituent units, are not large enough in children. Under influence various factors they can get damaged. Vertebral fractures are called compression fractures. With such an injury, the spine is strongly compressed, the damaged vertebra becomes wedge-shaped. Compression fractures are uncommon in children. But if they are not treated in a timely manner, this can lead to grave consequences up to and including disability.

What is a compression fracture

This is a very serious injury that a child can receive even while jumping or with a slight fall. If there is a calcium deficiency in the body, then the risk of such an injury increases.

"Compression" is translated as "compression". That is, a compression pearl in a child is a consequence of compression of the spine, followed by flattening of the vertebrae, their deformation and the formation of cracks. Typically, this fracture affects the lumbar and middle thoracic spine.

During a traumatic situation, the spine reflexively folds into an arc. The spinal muscles contract, the pressure on the anterior segment of the spinal column becomes greater. But most of the load falls on the middle of the thoracic region, which contributes to an increase in the limit of anatomical flexibility of the spine, the occurrence of wedge-shaped compression and a compression fracture.

Vertebral compressions are common in children aged 8-13 (especially in the middle thoracic region). At an older age, the lower thoracic and lumbar regions are more vulnerable.

Classification

Based on the volume of deformation of the vertebrae, there are 3 levels of fracture complexity:

1 (light)- the height of the vertebral body becomes lower by no more than 1/3;
2 (moderate)- half of the vertebral body is deformed;
3 (heavy)- the height is reduced by more than half.

At levels 2 and 3 of deformity, pathological mobility of the vertebrae appears. Compressions can affect only 1 vertebra, or they can be multiple.

There are several types of vertebral injuries:

wedge-shaped- front top part the vertebral body faces the sternum;
compression-tear-off- the anterior upper part of the vertebra is torn off, the line of rupture has uneven contours (seen in x-ray), the fragment is shifted down and forward;
fragmentation- there is a split of the vertebrae or even intervertebral discs into several fragments, the structures of the spinal cord can even be damaged.

Causes

Compression fractures can occur in children different reasons. The main one is mechanical damage:

falling from a height onto the chest or back, buttocks;
sharp bending of the back;
swipe in the region of the spine;
sudden weight lifting;
impacts when diving into the water (as a rule, compression of the cervical region occurs).

Predisposing factors for fracture may include:

features of the development of the spine, which make it weak, even if 1 vertebra is underdeveloped, the entire spinal column suffers;
presence, in which bone mass has a low density, as a result of this, even minor loads lead to injuries.

First signs and symptoms

According to the symptoms of a compression fracture in children, it can be:

uncomplicated- may be short term pain, often has a hidden clinical picture and be perceived as an ordinary bruise;
complicated- there is local pain with accompanying neurological symptoms, which is caused by damage to the spinal structures.

A characteristic sign of a compression fracture of the thoracic spine is girdle pain in the affected area, breathing may be held. At first, the pains are severe, mainly in the interscapular space, the chest is covered. For several minutes, it is difficult for the child to fully breathe. Gradually, the respiratory function is restored, the intensity of pain decreases, and the localization blurs.

For fractures of the lower thoracic and lumbar difficulty in breathing is not so pronounced. There may be pain in the abdomen. About 30% of children cannot stand up on their own after a fracture. But the majority immediately moves without resorting to outside help. Therefore, adults are in no hurry to see a doctor after an injury in a child.

If the child continues to live in the same rhythm as before the fracture, then the pain will continue further, the back muscles will quickly get tired. As a rule, after receiving a compression fracture, children are constrained in their movements, their gait changes, and lethargy is observed.

With damage to the cervical region, an increase in the intensity of pain is observed when turning the head. The neck is deformed. Neck muscles hurt and tense.

Diagnostics

Diagnoses a compression fracture in a child pediatric traumatologist. First, he conducts an examination, determines the localization of the injury. The doctor may identify an increase in the chest, which becomes arched. This indicates the wedge shape of the vertebrae. When the lower and middle thoracic region is damaged, the spinous process of the injured vertebra protrudes sharply.

CT and ;
electromyography;

General rules and methods of treatment

A child with a compression fracture of the spine should be isolated from any stress and call an ambulance as soon as possible. If he cannot move, then it is contraindicated to turn, pull. Before the arrival of the doctor, the child needs to be reassured, distracted from thoughts about the injury.

The patient is transported to the hospital in a supine position on a hard surface. This protects against damage to the spinal cord by possible fragments of damaged vertebrae.

Treatment of a compression fracture of the spine usually takes place in 3 stages:

Stage 1- up to 5 days, during which pain is relieved, the spinal column is unloaded. The child must strictly adhere to bed rest, lie on a hard surface (slope 30 o).
Stage 2- up to 2 weeks, restore blood flow in the damaged area through physiotherapy (electrophoresis), therapeutic exercises.
Stage 3- up to 10 days, the muscular corset is strengthened, physiotherapy, traction, massage, exercise therapy are carried out.

Conservative therapy

Uncomplicated compression fractures in children respond well to conservative treatment. To restore the vertebrae, you need to use. Opioids are usually prescribed for pain relief. The doctor selects the drugs individually for each patient, based on his age, weight, severity of damage.

In the absence of neurological symptoms, functional treatment. The spinal column is corrected by traction on a special inclined shield. To improve the flexibility of the spine, a method such as reposition is used. Consistently increase the angle of inclination of the rigid surface.

Rehabilitation

In case of damage to the vertebrae, a complex of physiotherapy exercises is required. Special exercises improve muscle strength, restore the work of the gastrointestinal tract, respiratory organs. About 2 months, thanks to exercise therapy, the muscle corset is strengthened. Gradually, the load on the injured area should increase, the duration of classes increases.

First, the child is given horizontal loads with a gradual transition to vertical ones. During classes, weights and resistances are used.

Thanks to the kneading massage for a compression fracture, it is possible to prevent the appearance of bedsores during strict observance bed rest.

Among physiotherapeutic procedures during rehabilitation use:

paraffin wraps;
magnetotherapy;
ultrahigh frequency techniques.

Find out the indications for use for the treatment of diseases of the back and spinal column.

The rules for performing therapeutic exercises and exercises for Bechterew's disease are described on the page.

Read the instructions for use on the page. pepper patch with osteochondrosis of the spine.

Surgical intervention

With moderate and severe forms Compression fracture in children resort to operations. These are usually minimally invasive techniques without direct incisions, which are performed under local anesthesia.

Methods of surgical intervention:

- a puncture is made in the skin, a special solution is injected, which hardens in the damaged vertebra.
Kyphoplasty - a thin tube with a miniballoon is inserted into the injured vertebra. It raises the height of the vertebra, forming a cavity in it. Then the can is removed, and the cavity is filled with a hardening solution.

Through surgery, you can:

reduce pain;
prevent the vertebra from lowering its height further;
return the spine to the correct shape of the bends;
prevent future fractures.

If the case is very severe, open surgery is performed under general anesthesia. Stabilization of a fractured vertebra is carried out due to its connection with neighboring ones with the help of special fixators.

A compression fracture in a child should not be ignored, even if the injury seems minor and the child feels normal. Untimely assistance may be fraught with complications in the future, very long-term rehabilitation. With any falls or bruises of the spine in a child, it should be examined to rule out serious damage.

The following video shows a set of exercises that are recommended for vertebral compression fractures in children:

The musculoskeletal system in childhood is not strong enough, because the bones are actively growing. Because of this, various injuries in a child are much more common than in adults, however, due to the high compensatory capabilities, fractures heal much faster, of course, if the necessary assistance is provided correctly and in a timely manner. For example, in case of compression injury of the spine, a whole range of measures is carried out, which includes physiotherapeutic procedures, massage, physiotherapy exercises, wearing a supportive corset, and in some situations it is indicated surgical intervention.

What is a compression fracture of the spine

The spine, which is the main part of the musculoskeletal system, consists of vertebrae - small bony rings that have a body, an arc and form the spinal canal containing the spinal cord.

A compression fracture, violating the integrity of the spinal column, primarily affects the vertebrae. Compression is understood as a strong and / or sharp compression, squeezing of the spine, as a result of which the anterior part of the vertebra (or several bone rings) acquires a wedge-shaped outline. In some cases, the vertebra is deformed so much that its fragments are embedded in the spinal canal, squeezing or damaging the spinal cord.

According to statistics, in childhood "suffer" following departments spinal column due to anatomical features:

cervical - in 1.5% of cases;
upper chest - 5.8%;
mid-thoracic - 61.7%;
lower chest - 21.5%;
lumbar - 9.5%.

The rarest and most dangerous in terms of undesirable consequences Compression injury of the spinal column in the cervical region is considered. It is fraught with paralysis of the respiratory muscles, and if the spinal cord is injured, the child is threatened with almost complete immobility.

Classification

When classifying a compression injury to the spinal column, several parameters are taken into account:

the degree of compression (deformation) of the vertebral body as a result of mechanical action;
damage features;
severity of symptoms.

Specialists distinguish 3 degrees of deformation of the vertebra in a compression fracture:

Light - the vertebra is reduced by no more than 30% of its original size.
Moderate - there is almost 50% compression of the vertebra.
Heavy - characterized sharp decline height of the vertebral body - more than 50%.

When studying the features of damage, doctors divide a compression fracture into the following types:

wedge-shaped. The anterior upper part of the vertebral body (facing towards the sternum) acquires a wedge-shaped shape.
Compression-tear-off. Such damage is a variant of the previous type of fracture. As a result of the injury, the anteroposterior part of the vertebra is torn off; the line of rupture with uneven contours. This fragment moves forward and slightly down, damaging the ligaments.
fragmentation. With such damage, the vertebral body and even the intervertebral discs are divided into several parts. shards posterior divisions vertebrae often penetrate the spinal canal, damaging the spinal cord.

According to the severity of symptoms, compression injuries of the spine are divided into two types:

Uncomplicated. The child feels short-term pain medium intensity immediately after the fracture. This type of damage is often latent as the parents accept serious injury for a normal injury.
Complicated. It is very easy to notice such a fracture, since in addition to pain, neurological symptoms are observed. Fragments of the vertebrae damage the spinal cord or nerve roots, which is manifested, for example, by loss of sensation.

Doctor about compression injury of the vertebrae - video

Causes of a compression fracture

The main cause of compression injuries of the spine in children is a strong mechanical effect. Most often, a fracture occurs when a child:

falls from a height onto the back or chest, legs or buttocks;
sharply bends the back during somersaults;
receives a strong blow to the region of the spinal column;
hits his head while diving (the so-called diving injury is the main cause of compression of the cervical spine).

Among the factors provoking the occurrence of a compression fracture in children, experts identify the following prerequisites:

A healthy spinal column can withstand fairly high physical activity. In the case of a weak or underdeveloped spine, even light loads lead to compression injuries.
Osteoporosis, which also occurs in children, reduces bone density, resulting in an increased risk of compression injuries even during normal activities: jogging, walking, squatting.
Due to the lack of vitamins and certain minerals (especially calcium), the condition of the whole organism worsens, including bone tissue and muscles. That is why the spine becomes weak and does not always withstand physical activity.

Quite often, compression injuries are combined with other injuries, for example, fractures of the arms and legs, pelvic ring, concussion. And the "fault" of this is children's mobility, since the child is able to fall during the game, in a physical education lesson and during any other activity.

Symptoms and signs

Not always symptomatic picture with compression of the spine, it is pronounced, especially if the fracture is uncomplicated. The main symptoms of spinal injury are pain of varying intensity and limited movement. The severity of these signs depends on the location of the fracture:

If the thoracic region is damaged, then the pain is localized in the interscapular region, but is usually girdle in nature. After the injury, the pain is strong, for 3-5 minutes there is a delay in breathing. In this case, the skin becomes pale and cyanotic. After recovery respiratory function painful sensations weaken and become less localized.
If the lumbar region is injured, breathing is preserved, however, the child develops severe pain in the abdomen, especially when turning over from the back to the stomach. In some situations, there is an increased tone of the spinal muscles and curvature of the spine at the site of injury.
If the child has injured the cervical spine, then the pain causes particular inconvenience when moving the head and when pressing on the damaged area.

More rare symptoms of compression fractures (in the case of a complicated injury) in a child are:

problems with urination;
violation of defecation;
partial paralysis of the limbs;
lowering blood pressure.

Sometimes, after an injury, a child is not able to get up and walk, so he is taken to the doctor in a supine position. Usually, with mild compression fractures, children move independently and relatively normally.

That is why some children get to the doctor very late, when their condition deteriorates significantly. That is why any back injury should seek immediate medical attention, as internal organs can also be damaged.

Diagnostics

Diagnosis of all types of fractures is carried out by a traumatologist who studies the circumstances of the injury, the clinical picture and examination data.

First of all, the doctor performs palpation (palpation) of the spine in order to determine the most sore spot indicating the damaged area. In the case of severe compression, which is accompanied by a displacement of the arches, pathological kyphosis is observed - an increase in the physiological curvature of the spine.

It should be understood that the examination does not always give an accurate picture of the violation of the integrity of the vertebrae. Therefore, traumatologists often prescribe a whole range of instrumental diagnostic methods:

X-ray of the spine is the main investigative procedure to detect the presence of a fracture. X-rays are carried out in lateral and direct projections in order to determine the location of the injury and its degree with great accuracy.
Magnetic resonance imaging (MRI) - optional diagnostic method, which is prescribed to confirm or refute suspicions of injury to nerve endings.
Computed tomography (CT) is used to examine the damaged area in more detail in order to detect changes in the structure of the bones. It is also necessary if a bruise has formed at the fracture site - CT will help detect internal hemorrhages.
Densitometry is an x-ray study of bone mineral density, which is indicated for suspected osteoporosis in a child.

It is important to differentiate a compression fracture from juvenile kyphosis (stoop), congenital wedge-shaped vertebrae, and other anomalies. In addition, to determine the presence of associated injuries, the doctor may refer the child to specialists in neurosurgery and neurology.

Child treatment

With mild compression injuries of the vertebrae, it is not uncommon for the child to be taken to the hospital by the parents, since the symptoms are mild, and the children remain mobile, complaining only of pain in the shoulder blades.

Doctors recommend immediately calling an ambulance for any spinal injury in children. If the child does not move, it is strictly forbidden to pull him, shake him up and try to turn him over on his stomach. Parents need to calm the injured baby and talk with him until the team of doctors arrives.

Transportation of the child must be carried out in the position that he took after the fracture, after laying him on hard surface. This will reduce the risk of damage to the spinal canal by fragments of the vertebrae, if they were formed during an injury.

A child who has received an uncomplicated compression injury is treated in a hospital, and then undergoes recovery in outpatient settings under the supervision of a surgeon or traumatologist. In the case of a complicated spinal injury, the terms of therapy are determined individually, and rehabilitation takes place in special centers.

The "classic" treatment of a compression fracture in a child consists of the following steps:

The doctor stops the pain syndrome with the help of a drug (taking into account the age of the patient). In especially severe cases, opioid analgesics are prescribed.
Based on the results of the diagnosis, the attending physician determines the severity of the fracture and chooses a conservative or surgical method for its treatment.
Then rehabilitation measures are carried out, which are aimed at restoring muscle tone and the function of flexion and extension of the spinal column.

Conservative therapy

Mild compression fractures are usually treated conservative method. To restore damaged vertebrae, a corset is put on the affected area. In addition, the following therapies are shown:

Functional. If the spinal body is compressed by a third, and there is no neurological damage, the doctor prescribes a correction of the spinal column for the child using longitudinal stretching on an inclined shield.
Reposition. This method involves a consistent increase in the angle of inclination of a rigid surface (for example, an orthopedic bed). The procedure allows you to gradually improve the degree of extension of the spinal column.

Surgical methods

For moderate to severe compressions, doctors usually prescribe surgical methods treatment. In childhood, low-traumatic (closed) operations under local anesthesia are shown:

Vertebroplasty. During this procedure, a special hardening solution is injected into the body of the damaged vertebra. This manipulation is carried out through a small puncture in the skin using a special needle.
Kyphoplasty. A method that allows you to restore the shape and height of bone rings. Using a thin tube, a tiny balloon is inserted into the damaged vertebra, which lifts his body and forms a cavity in it. Then the balloon is removed, and the resulting space is filled with a hardening solution. This procedure allows:

In especially severe cases, open operations performed under general anesthesia are indicated. Surgeons stabilize the vertebra by connecting it to neighboring ones with the help of special fixing elements.

Rehabilitation

Properly performed treatment is only part of the therapy for a damaged spine. Another extremely important element for the restoration of the vertebrae is a complex of rehabilitation measures. Their appointment and implementation depends on the severity of the injury, the presence of complications (for example, spinal cord injury) and the success of therapy.

Main restoration measures:

physiotherapy (paraffin wrap, ultra-high frequency therapy, magnet treatment);
massage (performed by a specialist, since the success of the entire course of treatment depends on the quality of the procedure);
swimming (children are often recommended to visit the pool in order to restore mobility to the spine and build muscle frame).

The main method of recovery after a compression fracture is physical therapy exercises (exercise therapy), carried out in parallel with other activities. With slight damage to the vertebrae, exercise therapy is prescribed from the very first days after injury.

Therapeutic exercise, like therapy, is divided into several stages, and the first three should be carried out in a supine position:

In the first 7 days after compression injury, simple exercises, the purpose of which is to improve the functioning of the gastrointestinal tract, heart and respiratory organs, as well as to prevent muscle atrophy. For example, the child is shown:
Exercises at the second stage (the next 2-3 weeks) are aimed at improving blood circulation, the formation and strengthening of the muscular corset. The child is allowed to perform exercise therapy lying on his stomach. Under the guidance of an instructor, the child:
At the third stage, which lasts about a month, the child's spine is prepared for a vertical position through the strengthening of the pelvic and dorsal muscles. Exercise features:
The last stage of exercise therapy is characterized important event: the child gets out of bed. Therefore, it is important to ensure that the spinal column gets used to the vertical orientation and restore the general motor activity. Children perform exercises, leaning on a bed or a wall:

Even after graduation rehabilitation period The child has been followed up for several years. All this time, therapeutic exercises are shown under the supervision of specialists.

Therapeutic exercises at home - video

Lifestyle and nutritional habits

When treating and rehabilitating a compression injury to the spine, it is important to follow all the doctor's instructions. For example, it is necessary to monitor active children who find it difficult to comply with bed rest and limited movement.

After the child returns home, it is worth making sure that he wears a corset (if necessary), takes medicines to strengthen bones, refrained from excessive physical exertion and attended sessions of therapeutic massage.

In addition, parents of young patients need to adjust their diet in order to strengthen and restore bone tissue. To do this, the diet includes foods with high content the following vitamins and minerals:

calcium - in large quantities present in dairy products, including cheese, legumes, nuts, sesame seeds, herring and salmon fish;
magnesium - present in nuts, lettuce, bananas and seafood;
zinc - found in large quantities in cocoa powder, seafood, nuts, beef, buckwheat;
vitamin B6 and folic acid- these elements are present in the liver, legumes, beets, bananas.

For the duration of treatment and rehabilitation, it is necessary, as far as possible, to refuse foods that leach calcium from the bones ( strong coffee and tea, soda) and prevent its normal absorption ( fatty food). Cheese is a tasty and healthy "supplier" of calcium. Curd contains calcium that is easily digestible by the body.
Legumes, especially beans, are high in calcium.
Possible complications and consequences
Rehabilitation of a child after a compression fracture of the spine takes long time and requires great patience from parents. The most favorable prognosis concerns mild vertebral damage, which usually ends with a complete recovery.
In case of untimely seeking medical help or a complicated fracture, complications such as:
curvature of the spine - post-traumatic kyphosis and scoliosis;
osteochondrosis ( degenerative changes in intervertebral discs, vertebrae and nearby joints);
spinal stenosis;
damage to the nerve roots, which in some situations leads to paralysis.

Of course, it is almost impossible to protect a child from various injuries and falls. However, parents can still prevent the occurrence of a compression fracture if they provide children with proper nutrition, rich in calcium and vitamins, the required level physical activity, and also do not forget about regular examinations of the child's skeleton. Only in this case children's spine stay strong and healthy.

A fracture occurs due to the action of a force that is much greater than the resistance of the bone. The compression fracture of the spine in children is no exception, which often occurs as a result of injury. With this injury, a bruise of the head occurs, deformation of the spinal column in the area of injury, swelling of the soft tissues, a disorder in the activity of the limbs and organs of the small pelvis, and severe pain appears.

Most often, an injury is diagnosed in the thoracic spine, when several vertebrae are simultaneously damaged, located next to or through several sections. Doctors are not always able to determine the connection with injury and.

A compression fracture of the spine in a child is an injury to the vertebrae, which leads to a functional disorder of the musculoskeletal system, as well as a disorder in the depreciation, protective and balancing properties of the spinal column.

Compression is a sharp strong compression, so a compression fracture is an injury to the spinal column due to its compression or compression, which leads to damage to the vertebrae, they become wedge-shaped.

Sometimes fragments of the vertebrae enter the spinal canal and damage the spinal cord. Often this pathology is observed at the age of ten to fifteen years due to increased activity teenagers. Usually it is combined with craniocerebral injury, fractures of limbs, trauma chest, dislocations of the vertebrae.

If you do not start treating the pathology in time, this will lead to the disability of the child due to the development of kyphosis, scoliosis or aseptic necrosis. Usually fractures in childhood proper treatment grow fast and well.

Compression fracture of the thoracic spine in children often occurs with a slight load. Often this takes place in a latent form, while the vertebrae are compressed and become wedge-shaped.

A fracture of the cervical spine is considered especially dangerous in medicine. In this case, damage can lead to paralysis of the respiratory muscles, and if the spinal cord is injured, complete paralysis may develop.

In medicine, there are several degrees of severity of pathology:

Mild degree, in which the vertebra is reduced by 30%;
A moderate degree is characterized by a decrease in the vertebra by half;
Severe degree is caused by compression of the vertebra by more than 50%.

Also, fractures are uncomplicated, which often occur hidden and are perceived as a bruise, and complicated when they develop neurological signs. In the latter case, the fragments contribute to damage to the spinal cord and nerves.

Also, compression fractures of the spine in children can be of several types:

A wedge-shaped fracture is characterized by the acquisition of the anterior part of the vertebrae in the form of a wedge.
An avulsion fracture is caused by the tearing off of the anterior part of a vertebra, in which the fragment is mixed forward and downward, injuring the ligaments.
A comminuted fracture, in which the body and disc of a vertebra are crushed into pieces, some of which enter the spinal cord and damage it.

Due to the strong flexibility of the spinal column in childhood, as well as the large interdiscal gap, a fall from a small height can cause injury.

Causes of injury

Usually, a fracture of the spine in children occurs due to their falling from a long distance on their back or down, diving, improper bending of the spine during somersaults, the consequences of an accident, and the fall of heavy objects on the head or shoulders. Depending on which part of the body was hit during the fall, various vertebral sections may be affected, but most often it is the thoracic section.

Also, a fracture can provoke a weak spine due to improper development child, the presence of pathologies of the musculoskeletal system. Especially often children with osteoporosis, osteomyelitis, metastases of a cancerous neoplasm suffer.

Even with a small load on the spinal column, damage can occur. Often the cause of fractures are birth injury spine, which are observed during childbirth.

Physicians distinguish such prerequisites for the occurrence of this pathology:

The main reason is child mobility. The child will always be injured, so it is important to keep an eye on your children.

Symptoms of the disease

A compression fracture of the spine in children manifests symptoms in the form of severe pain at the site of the lesion, as well as short-term apnea. Pain syndrome spreads to the chest area, there is difficulty in breathing for several minutes, the child cannot inhale or exhale air with full force, the head is forced to tilt, it is difficult to move it, the neck muscles tense.

Sometimes children cannot stand up on their own, they have to be hospitalized in a medical facility in a lying position. In some cases, blueing is possible skin. After a while, breathing normalizes, the pain decreases, the ability to move independently returns.

According to statistics, only 30% of children go to a medical facility on the day they are injured. Often parents self-medicate, which can lead to the development of serious complications.

The pain syndrome subsides after a few days if the child lies in bed. With further activity after the injury, the pain intensifies, he begins to tire quickly. Most often, after a fracture, children become inhibited, their movements are constrained, and their gait is disturbed.

Signs of a compression fracture of the spine in children, in particular the cervical region, manifest themselves in the form of pain, which becomes stronger when moving the head. The neck is bent, the muscles are tense.

Often, when injured, the arms and legs, as well as internal organs, suffer. When the lumbar region is damaged, there are pains in the peritoneum, swelling and bruising of soft tissues, curvature of the spinal column, and muscle tension.

With a complex fracture, paresis occurs, urination and defecation are disturbed, numbness develops, pain spreads to the bones, areflexia, hypotension, osteochondrosis, disc herniation, kyphosis, kyphoscaliosis, disruption of vital activity. important organs.

Hard breath;
Muscle tension;
Swelling of soft tissues;
Stiffness of movements;
Abdominal pain.

With a complicated fracture, the functionality of the spinal cord is impaired, which can cause disability and even death.

Patient examination

An experienced traumatologist knows how to determine a compression fracture of the spine in a child. First, the doctor takes the history and possible reasons injury. Then he conducts an examination, in which it is often possible to detect kyphosis of the thoracic region, and palpation to determine the painful area. When the first and second vertebrae are affected, the protrusion of the spinous process of the injured vertebra is observed.

X-ray, which establishes the severity of damage and its location;
Electromyography;
Scintigraphy;
CT or MRI to detect damage to nerves, bone structure, internal hemorrhages;
Densitometry for suspected osteoporosis.

Additional diagnostic methods x-rays of the skull, chest and peritoneum, ultrasound of internal organs, and others may appear. Also, the traumatologist differentiates pathology from diseases such as apophysitis, kyphosis, congenital wedge-shaped vertebrae and other anomalies in the development of the spinal column.

Treatment Methods

Often a doctor provides first aid on the spot. In this case, the type and degree of fracture, its localization is determined. The patient is then given an anesthetic and transported to horizontal position to a medical facility using immobilization.

Use for neck injury transport tire CITO or Cramer. In this case, the development of apnea is observed, so it is necessary to temporarily fix the tongue with an instrument or crayfish to prevent it from sinking. The child's head should be turned to one side and slightly lowered. In case of damage to other parts of the spinal column, the patient is placed on a rigid stretcher with his stomach down, putting a pillow under his head and shoulders.

In a hospital, a compression fracture of the spine in children is treated primarily by traction of the spine.

With an uncomplicated fracture, special therapy is not required, the doctor prescribes wearing a corset for two months to prevent deformation of the vertebrae and compression of the spinal cord.

Exercise therapy, breathing exercises, massage, physiotherapy procedures can also be prescribed. After two months, the child is allowed to walk a little, and after four months - to sit. Reposition can also be used, when the doctor gradually increases the angle of inclination of the orthopedic bed in order to gradually improve the degree of extension of the spine.

Exercise therapy is used to improve the activity of vital organs, normalize muscle tone, strengthen them, and prepare the spine for future physical activity.

Severe injuries require surgical intervention. The following methods can be used for this:

Surgical intervention is performed to reduce pain, prevent the lowering of the injured vertebra, restore the natural curves of the spinal column, and reduce the risk of fractures in the future.

In extremely severe cases open surgery is performed, in which the vertebra is stabilized as a result of its connection with neighboring structures using special fixators. The operation is performed under general anesthesia.

After the operation, the spinal column is fixed by applying a cast or wearing an orthopedic corset. Some time after the operation, massage, exercise therapy and FTL are prescribed. These methods enable self-healing damaged tissues, strengthen back muscles and prevent bedsores.

When the child returns home, parents should monitor his activity, wearing a corset, taking medication to strengthen bone tissue, and attending massage sessions. Parents should also monitor their child's diet.

By including in his daily diet foods that contain vitamins and minerals, in particular calcium, magnesium, zinc and vitamin B6. Not recommended for eating fatty foods and carbonated water.

Complications and consequences

It takes a long period of time to fully restore the spine. In severe cases, spondylitis, kyphosis, osteochondrosis, stenosis, instability of the vertebrae, as well as a violation of the activity of organs and systems, may occur.

In some cases, the child may become disabled due to necrosis of the spinal column. Doctors recommend contacting a medical facility in a timely manner to reduce the risk of complications.

Forecast and prevention

A favorable prognosis is given when there is a compression fracture of the spine of the 1st degree in children. In this case, a complete recovery is possible. In other cases, incomplete recovery or complications may develop. After treating the injury, doctors observe the affected children for about two more years.

Preventive measures should be aimed at preventing child injuries. Adults should closely monitor children, organize their safety during leisure time, and also conduct explanatory work among them.