How to treat thoracic vertebrae fractures

The thoracic vertebra is a very important part of our body. Sometimes we will feel pain if we accidentally bump into it. People often suffer multiple fractures in their bodies due to accidents such as car accidents or falls from buildings, including thoracic vertebrae fractures. The pain at this time is naturally unbearable for ordinary people, and even breathing will hurt. So how should we treat it?

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.

(2) Timing of surgery The timing of surgical intervention (decompression and stabilization) for patients with spinal cord or cauda equina injuries is not entirely clear. Although there is insufficient evidence from human clinical studies, there may be an important time window (possibly <3 hours) during which decompression may promote recovery of spinal cord function and improve prognosis. Patients with spinal deformity and spinal cord injury caused by acute trauma should undergo emergency surgery to restore spinal alignment and create the greatest possibility for spinal cord recovery. Because posterior approach surgery is an indirect decompression method that relieves spinal canal compression through ligament reduction, it can be performed more smoothly in the early stages of trauma.

From the above article we can see that both conservative treatment and surgical treatment require a certain amount of time, and the process is very painful. It is difficult for many people to persist and their physical condition cannot be changed. A thoracic vertebra fracture looks very sad, so you must take precautions to prevent yourself from getting a thoracic vertebra fracture!