Compression fracture of the spine in a child: symptoms, treatment

In children, the bones are in the process of growth, so they are often subjected to various injuries. One of the most serious is the compression fracture of the spine. At the child he meets rarely, but such a trauma can have dangerous consequences. Therefore, each parent needs to know how to prevent such damage, how to recognize that a fracture happened, and how to properly provide first aid. Although in children the bones coalesce faster than in adults, but treatment after such trauma, together with the rehabilitation period, usually takes at least two years.

What is a compression fracture?

This is a serious spinal injury, which is a violation of the integrity of one or more vertebrae due to their contraction or sharp squeezing. Often it is accompanied by swelling of soft tissues, infringement of nerves or vessels. Vertebrae can not only contract or flatten, but even crack. This happens when jumping or falling from a height, impact or sudden movement. Most often, there is a compression fracture of the thoracic spine in children or in the lumbar region. Compression of the vertebrae can lead to damage to the spinal cord and paralysis of the limbs. According to statistics, such traumas occur in children rarely. After all, before full ossification, the spine is quite flexible, and the intervertebral discs are high.

Causes of injury

Compression fracture of the spine in the child can happen even from a minor impact or a fall on the buttocks. This is more common in children whose bones lack calcium. This happens with osteoporosis or osteomyelitis. But any child can be injured. The causes of compression fracture most often are:

• Fall, especially dangerous is when the landing takes place on the buttocks;
• Unsuccessful diving into the water;
• A sharp slope or an incorrectly executed somersault;
• car crashes.

Signs of compression fracture

Sometimes the injury happens in mild form. In such cases, parents may not understand that the child has a compression fracture of the spine. Symptoms of uncomplicated trauma are smeared and resemble signs of a bruise. Therefore, it is important for any fall on the back or buttocks, hitting the spine immediately to see a doctor. It is necessary to conduct a survey and find out whether there is damage.

Often, it is possible to determine by outward signs and complaints of the child that he has a compression fracture of the spine. Symptoms will differ, depending on the type and location of the injury.

• With a fracture in the thoracic vertebrae, pain in the shoulder blades is felt. Then it covers the entire thorax. In addition, the child experiences breathing problems.
• If the lesions have affected the lumbar vertebrae, abdominal pain and pectoral muscle tension may occur. Any movement is given to the child with difficulty.
• Forced head position and marked deformation in the neck indicate a fracture of the cervical vertebra. The child experiences severe pain, and the neck muscles are tense.
• More serious symptoms are accompanied by a complicated fracture. Damage of blood vessels and nerves leads to numbness of the limbs, partial paralysis is possible. There is an upset urination, muscle weakness and low blood pressure.

The most important sign of any compression fracture is pain. It can be strong at first, and then almost disappear, or, conversely, will intensify.

Types of spinal injuries

By the presence of complications, such damage can be complicated and uncomplicated. The danger of the first type is that a child can not say about a small back pain. And without treatment, such a trauma has serious consequences. Among the complicated, the compression fracture of the thoracic spine is especially dangerous. Its consequence may be a violation of the heart and lungs.

Depending on the degree of deformation of the vertebrae, three types of trauma are identified.

• Compression fracture of the first degree is characterized by a decrease in the height of the vertebra by 30%. Such a trauma is successfully treated and with a timely treatment, the prognosis of therapy is favorable.
• A fracture of the second degree is the compression of the vertebra by half. In most cases serious complications arise after this.
• Deformation of more than 50% refers to very serious injuries and is rarely diagnosed in children. Usually a third degree of fracture is characterized by damage to the spinal cord.

Diagnosis of trauma in children

The back pain itself is not the basis for diagnosing "compression fracture of the spine". At the child such sensations can appear and for other reasons. Therefore, if you suspect a damage, you must visit a trauma specialist. He will prescribe diagnostic procedures that will help to make the correct diagnosis.

• First of all, X-rays are made in two projections. This helps to identify where the damage occurred and what its nature is.
• The condition of the spinal cord and the examination of the injured spine is done with the help of CT and myelography.
• If there are signs of nerve root damage, MRI of the spine is performed. Its price is from 2.5 to 7 thousand rubles, but this method of investigation is really informative.
• You can do more densitometry, which will help to identify the child's osteoporosis.

Features of first aid

The main rule that must be observed by adults who are next to the child during an injury is to prevent the vertebrae from moving and further deforming. To do this, it is necessary to ensure the immobility of the victim and his prompt delivery to the hospital. Injuries to the spine are very serious injuries, so it is very important to know how to give them first aid.

• With a compression fracture in the lumbar region, you need to put the baby on your stomach, putting something soft under your head.
• In trauma in the thoracic region, it is important that the child is lying on his back on a flat, solid surface.
• Fracture of the cervical vertebra is especially dangerous because the slightest careless movement can lead to damage to the spinal cord. Therefore, you can not touch, much less try to straighten the deformity of the spine. It is necessary to cover the baby's neck with cotton or something soft and bandage.
• With any injuries of the spine, the injured person should not sit, walk or even turn around.

Compression fracture of the spine in children: treatment

The methods of therapy depend on the type of fracture. Complicated trauma is treated only with the help of surgical intervention: insert titanium plates or fill cavities in the damaged vertebra with special cement. But such traumas in children are rare. Therefore, the most demanded method of treatment of uncomplicated fracture. For the prognosis of therapy to be favorable, timely assistance, long-term comprehensive treatment and consistency in the application of various methods are necessary. The most effective at such a trauma is LFK, massage, breathing exercises and physiotherapy.

Compression fracture treatment is performed in several stages:

1. The first 3-4 weeks after injury. All this time the child is in the hospital. Treatment consists in strict bed rest and stretching of the spine with the help of the Glisson loop or the Delbe rings on an inclined bed. The purpose of this therapy is to relieve the muscle strain, prevent even more severe deformation of the vertebrae and protect the spinal cord from damage. The first few days you still need to remove the pain.
2. In the second month after the injury, the task of treatment is to restore the function of muscles and ligaments and prepare the spine for motor exercises. After an uncomplicated fracture at this time the child can already get up for a short time. The victim must lie on a firm, level surface without a pillow.
3. Almost a year after the injury, active restoration of the spine functions. At this time, rehabilitation measures are being carried out to restore mobility to muscles and ligaments.
4. After that, for another year, you need to continue to perform a special complex of exercise therapy and physiotherapy. And only after two years after the injury can we talk about a successful cure.

Compression fracture of the spine: rehabilitation

To get up and walk a child is allowed 1-2 months after the injury. It depends on the severity and nature of the damage. The first time in the vertical position can only be in a special corset. The doctor appoints the time of wearing the orthosis individually. But most of the day the child spends his first year lying on his back or on his stomach. Sitting the same victim can not be long. Usually it is allowed to sit down after a compression fracture of the spine only after 4-8 months. The corset is worn for at least a year, depending on the nature of the damage.

The tasks of rehabilitation after such trauma are to restore the mobility of the spine, the work of the ligaments, to strengthen the muscular corset and to regulate blood circulation. For this, the courses use physiotherapeutic procedures. It is very important that during the next two years the child regularly performs special exercises of physiotherapy exercises.

Physiotherapeutic procedures and exercise therapy

They are appointed a week after the injury. This can be electrophoresis with euphilin for capillary expansion, magnetotherapy, improving blood circulation, electromyostimulation. UHF, paraffin applications, water procedures are also prescribed. It is very effective massage, which is done after the disappearance of pain and is conducted by courses several times during the next two years.

But the main method of treatment of a compression fracture is LFK. Its tasks are to strengthen the muscular corset, improve blood circulation and stimulate the work of the gastrointestinal tract. Begin to perform exercise therapy within 3-5 days after the injury. First it's breathing exercises, muscle tension and lifting hands. It is forbidden to raise the head and legs in the first month. After the disappearance of pain is allowed for a short time to roll over on the stomach. The first 1-2 months of exercise are performed only in a prone position. After this, an individual complex is set up for training in an upright position.

Possible consequences of injury

Most often there is an uncomplicated compression fracture of the spine in a child. Usually recovery after a trauma is successful, and after a couple of years the victim can forget about the damage. In 90% of cases, such fractures are without consequences. But with untimely care or lack of treatment, and after a more serious injury, there are often complications:

• Curvature of the spine, most often scoliosis and kyphosis;
• After a while develops osteochondrosis;
• A frequent consequence of a compression fracture is radiculitis;
• The stenosis of the vertebral canal is very dangerous, which leads to a worsening of blood circulation;
• The most severe consequence of trauma can be complete paralysis of the lower extremities.

Prevention of compression fractures in children

In fact, it is very difficult to protect the child from falls. But parents need to know that those most affected by fractures with minor injuries are those who suffer from osteoporosis. Therefore, it is necessary to regularly examine the skeleton of a child and not to allow a lack of its diet of calcium and vitamin D. After each fall, especially on the back, it is advisable to undergo a survey. The most informative is the MRI of the spine. The price is quite high, but the survey will help in time to identify the damage and avoid complications.

It is important that parents provide the child with the right nutrition and the right level of movement. It is necessary to protect it from jumping from a height, lifting weights and sharp slopes. Then the child's backbone will always be strong and healthy.