Rehabilitation after a compression fracture of the spine

As a result of an accident, after a fall from a height on the legs or pelvic region, a compression fracture of the spine occurs. Treatment and rehabilitation of an injury is a complex of measures, the main goal of which is a complete functional recovery.

What is a compression fracture of the spine

A compression fracture is an injury in which a part of a vertebra is pressed in, which occurs as a result of excessive force along the axis. The injury takes place against the background of various accidents, which are accompanied by a fall of a person from a height onto his legs or pelvic area. Often it occurs after exposure to a relatively small force (body weight, cough). In this case, a pathological compression fracture develops, which is the result of a decrease in the strength of bone tissue (osteoporosis of various origins). The favorite localization of traumatic and pathological fractures is the lower third of the thoracic and lumbar spine.

Regardless of the origin, the injury immediately manifests itself with pain of varying severity (depending on the pain threshold of the person), which has the greatest intensity in the area of ​​the damaged vertebrae. Often, pain is given to the limbs on one or both sides. At the same time, discomfort is subjectively felt in the form of skin numbness or tingling.

Insufficient or incorrect functional recovery of a person after an injury or a pathological fracture leads to discomfort, a decrease in the quality of life, disability, and disability.

The main rehabilitation measures, their features

Rehabilitation after a compression fracture of the spine is a complex event that includes several areas:

• Therapeutic physical education (LFK) or gymnastics is the main direction, it involves the performance of special exercises with a gradual increase in load to adapt the structures of the spine.
• Massage - stroking, rubbing, kneading the skin and subcutaneous tissue increases blood flow in the tissues of the area of ​​traumatic or pathological damage, promotes rapid healing, increased strength. Massage almost always complements therapeutic exercises and is performed after a set of exercises.
• Physiotherapy is a variety of medical procedures that involve the impact on tissues of certain physical factors. These include laser therapy, electrophoresis with various drugs, magnetotherapy, ozocerite. Physiotherapy is not always prescribed, but only if there are certain indications that are identified by the attending physician, an orthopedic traumatologist or a rehabilitation specialist.
• Corset - the product is used to normalize the tone of the striated muscles of the back, restore posture. Rehabilitation after a compression fracture of the spine in children necessarily includes wearing a corset for several hours a day for a month.

Also, in the course of rehabilitation activities, alternative methods may be prescribed, which include yoga, swimming in a certain style, balneological procedures. They are prescribed individually at the last stages of restoration of the functional state of the spine.

Duration of rehabilitation measures

Several factors influence the duration of rehabilitation. Depending on the severity of anatomical changes, the nature of the injury, the location of the compression fracture, 3 groups of patients are distinguished:

• Patients with a compression fracture, in which the spinal cord was not affected or received minimal damage that does not affect the functional state - rehabilitation lasts an average of about 8 months. It includes therapeutic exercises, massage, physiotherapy and the use of certain drugs (vitamins, calcium preparations). After carrying out the measures, the severity of pain sensations decreases, the strength of the anatomical structure of the damaged area is restored, and motor activity is improved. The duration of recovery is on average about 1 year.
• Patients with a moderate spinal injury and spinal cord injury in the lower part of the thoracic region or lower back - rehabilitation measures are aimed at restoring the motor activity of the lower extremities, the functions of the pelvic organs. They additionally include reflexology, physiotherapy, the appointment of drugs that have a positive effect on the state of the cells of the nervous system.
• People who have suffered a severe spinal injury with spinal cord injury in the upper chest or neck - activities are aimed at restoring basic skills aimed at self-care of a person (self-catering, dressing, moving in a wheelchair). Rehabilitation after a compression fracture of the spine of the thoracic spine, neck includes massage, passive gymnastic exercises, physiotherapy, administration of drugs of various pharmacological groups. The prognosis for severe spinal cord injury in the neck remains unfavorable, since it is very difficult to achieve an improvement in the functional state and the ability of a person to self-service. The duration of the rehabilitation measures is at least 2 years.

Full-fledged rehabilitation of patients from the 4th group makes it possible to partially serve with the help of additional technical means.

Stages of exercises

The basis of rehabilitation after a compression fracture of the spine, regardless of the location and severity of the changes, is the implementation of therapeutic exercises and physical education (exercise therapy), which include 4 stages. On each of them, certain sets of exercises are mainly assigned.

First stage

The stage is aimed at normalizing the state of the respiratory and cardiovascular systems, increasing the tone of the striated skeletal muscles. One lesson lasts on average about 15 minutes and includes exercises that are performed in the position of a person lying on his back:

• taking deep breaths and exhalations;
• lifting the pelvis based on the feet and shoulder blades;
• flexion and extension of the fingers, rotation of the hands;
• alternating abduction of hands to the right and left sides with simultaneous turns of the head;
• abduction of each leg to the sides without lifting, while the hands are located on the belt.

The average duration of the first stage is 14 days.

Second phase

The purpose of the exercises is to normalize the work of internal organs, strengthen muscles, and accelerate tissue regeneration. They are performed with the patient lying on his back and stomach:

• raising the head and shoulders, while the emphasis is on the hands and elbows;
• bringing the hands to the shoulders with the maximum dilution of the shoulder blades to the sides and the simultaneous lifting of the head;
• lifting the legs due to flexion in the hip joint;
• slow rollovers from back to stomach and vice versa;
• foot movements that mimic pedaling while cycling;
• deep, even breathing after all exercises.

The average duration of the second stage of therapeutic exercises is 4 weeks.

Third stage

The goal is to create small axial loads on the spine to adapt and strengthen the tissues in the area of ​​the fracture. Exercises improve mobility between the vertebrae, as well as the functional state of the vestibular apparatus, they are performed in a kneeling position:

• alternately abducting the arms to the sides while raising the head;
• simultaneous lifting of the arm and head up;
• abduction of the right, then the left leg back;
• slight torso to the right and left;
• kneeling forward and backward, then to the sides.

The average duration of the third stage is 2 weeks.

Fourth stage

The last stage of therapeutic exercises is aimed at adapting the spine to a vertical position, as well as preventing posture disorders. Initially, the patient stands up for a short period of time. Then walking is allowed, the duration of which should not exceed 20 minutes a day. The stage begins no earlier than 2 months after the compression fracture. It lasts several months on average.

Complications

In the absence of rehabilitation or improper implementation of measures, a compression fracture of the spine has an unfavorable prognosis with the development of the following complications:

• Violation of the motor function of the limbs and skin sensitivity of varying degrees of severity and localization.
• Change in posture, the formation of curvature of the spine in the thoracic or lumbar region.
• The development of degenerative-dystrophic pathology of the joints between the vertebrae (osteochondrosis).
• Infringement of the spinal roots with the subsequent development of an inflammatory reaction.

The development of complications reduces the quality of life of a person, leads to disability, which requires constant care.

After exposure to excessive force along the axis of the body, a compression fracture of the spine develops. Rehabilitation after treatment includes a set of measures that help restore the functional state and mobility of the spine. Measures are prescribed by the doctor individually, depending on the severity of the changes.