What is the treatment for thoracic vertebrae fractures?

The chest is protected by a large piece of bones, among which the thoracic vertebrae seem to have no use, but they play a very critical role in the healthy balance of the chest. The thoracic vertebrae are almost identical in shape to the lumbar vertebrae, but are located above the lumbar vertebrae. They are critical to the balance of the body above the chest. A thoracic vertebrae fracture will disrupt this balance, making it impossible to move freely above the chest, and the pain is extremely intense. For patients, the pain is extreme and even exceeds the pain in the lumbar spine. Let’s take a look at how to treat thoracic vertebrae fractures.

Thoracolumbar fracture refers to the destruction of the continuity of the thoracic and lumbar bones due to external force. This is the most common spinal injury. Among young and middle-aged patients, high-energy injury is the main cause of injury, such as traffic accidents, falls from heights, etc. Due to osteoporosis in elderly patients, the injury factors are mostly low-violence injuries, such as slips and falls. Patients with thoracolumbar fractures often suffer from neurological damage, and because the injury factors are basically high-energy injuries, they are often accompanied by injuries to other organs, which brings great difficulties and challenges to treatment.

1. Conservative treatment

Limited to A1 and A2 type fractures, the indications are: ① no neurological damage; ② at least two of the three columns of the spine are intact; ③ the kyphosis angle is less than 20°; ④ the spinal canal encroachment is less than 30%; ⑤ the vertebral body compression does not exceed 50%.

Conservative treatment is a basic treatment method for thoracolumbar fractures. The main method is external fixation with a brace or bed rest treatment, which includes a period of bed rest until the systemic symptoms are relieved, followed by the use of a brace for 10 to 12 weeks and gradual functional exercises.

2. Surgery

(1) Indications for surgery: ① Nerve injury; ② All C-type fractures; ③ A3 and B-type fractures with an angle exceeding 30°, vertebral compression exceeding 50%, and spinal canal encroachment exceeding 30%; ④ MRI confirmed intervertebral disc injury.

Compared with external fixation or bed rest, surgical treatment has several advantages. First, it can provide immediate stabilization for patients who cannot tolerate bracing or bed rest. In a polytrauma patient, prolonged bed rest may result in serious life-threatening complications. Timely surgical stabilization can allow the patient to sit up and undergo rehabilitation treatment early; secondly, surgery can well restore the spinal sequence and correct the deformity; finally, it can relieve pressure on the nervous system.