How to treat lumbar fracture?

The lumbar vertebra is a part of the spine, and the lumbar vertebra is the lower half of the spine. It plays a connecting role for the entire spine. The lumbar vertebra mainly undertakes the coordination function of the entire body, allowing the waist to twist at will and complete various movements specified by the brain. When the lumbar spine is under long-term pressure, more serious symptoms will appear. For example, symptoms of low back pain often occur, which adds a lot of trouble to life. Moreover, there are not many treatments for low back pain, and it takes a long time to fully recover. Let’s take a look at how to treat lumbar fractures.

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.

(2) The purpose of surgery is to ① create the best conditions for spinal cord recovery; ② restore and maintain the height and curve of the spine; ③ reduce the loss of spinal mobility; ④ maintain the stability of the spine; ⑤ firmly fixate to facilitate early care and rehabilitation; ⑥ prevent post-traumatic kyphosis and neurological damage.