Spinal fractures

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Spinal fractures : 

Spinal fractures Clinical features, Principles of Management, and Complications

Spinal Fractures : 

Spinal Fractures Epidemiology-2/100000

Injuries : 

Injuries Stable Unstable

Mechanism of Injury : 

Mechanism of Injury Flexion Flexion-rotation Vertical compression Extension Flexion-distraction Direct Indirect Injury due to violent muscle contraction

Clinical Features : 

Clinical Features Pain Numbness Difficulty in moving the Limbs Tenderness Paraspinal swelling Absence of Reflexes in flaccid limbs Painless urinary retention Neurogenic Paradoxical ventilation

Neurological Injuries : 

Neurological Injuries spinal cord injuries by the area of the spine involved and its clinical features. Referred to as syndromes * Anterior cord syndrome - an injury to the anterior portion of the spinal cord. This injury usually involves paralysis below the level of injury and the loss of pain and temperature sensations. However, patients can usually still feel touch, motion, and vibration and are able to sense the movement of their bodies.

Neurological Injuries : 

Neurological Injuries *Central cord syndrome - results from swelling in the spinal cord. This most often occurs in the cervical spine and includes difficulties moving and feeling the arms, as well as bowel and bladder dysfunction. *Brown-Sequard syndrome - often the result of penetration injuries such as stab or gunshot wounds, or from spinal cord tumors. This involves loss of movement on one side of the body (the side were the injury occurred) as well as the loss of pain and temperature sensations (on the opposite side of where the injury occurred).

Investigation : 

Investigation X-ray CT Scanning MRI

Treatment : 


Treatment : 

Treatment Phase 1:Emergency Care Examination-Hypovolemic shock, Neurological deficits, Spine injury, Haematoma Phase 2:Definitive Care Avoid Deterioration of neurological Status Achieve Stability Phase 3:Rehabilitaion

Management : 

Management SpinoMed…

Operative management at specific Sites : 

Operative management at specific Sites Odontoid #:Rigid immbolisation Cervical #:Reduction Skull traction-Tongs or calipers, Stable #:Cervical collar, or SOMI Brace for 6 weeks Unstable #: operative fixation, 12 weeks of skull traction or Halo, ORIF Thoracolumbar#:Minerva Jacket, Halo pelvic traction Stable#:ASH Brace

Operative management at specific Sites : 

Operative management at specific Sites Unstable #:Decompression, and internal fixation like- Harrington instrumentation- bilateral Luque Instrumentation Hartshill Rectangle fixation Pedicle Screw Fixation

Management : 

Management Stabilize and align the vertebral column Improve neurologic status Return the patient to functional status as soon as possible Two types of exercises weight-bearing resistance exercises

Management : 

Management These fractures almost always require surgical interventions that are designed to: • Stabilize and align the vertebral column • Improve neurologic status • Return the patient to functional status as soon as possible

Management for paralegics : 

Management for paralegics Daily care and Rehabilitation Features- Skin care-Pressure sores Urinary tract-Catheterisation, and Automatic Reflex function Limbs-Prevent Contractures, and Work on ROM

Complications-????? : 


Complications : 

Complications Decreased appetite and sleep disorders Reduced days of activity and more days in bed Chronic back pain and fatigue Decreased quality of life Feelings of isolation and sadness Increased risk for future fracture Increased risk of death

Complications : 

Complications Kyphosis Reduced mobility, loss of balance and increased risk of falls Reduced lung function Reduced ability to take care of yourself or perform your usual work or retirement activities

Risk Factors : 

Risk Factors Prior fracture Age Medications Diseases Diet Vitamin D Exercise

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Reference : 

Reference Essential Orthopedics- Maheshwari(3rd edition) Neurology And Neurosurgery illustrated-Lindsay (4th edition) Orthopedics- Natrajan

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