FRACTURES
Part 4
This is a continuation of our discussion of the topic, FRACTURES.
Fractures Caused by Extension
Treatment for extension injuries will depend on various aspects of the injury, including:
• Which part of the spine is damaged
• How much damage has occurred because of the fracture
Nonsurgical treatment. Extension fractures that occur only through the vertebral body can typically be treated without surgery. These fractures should be observed closely while the patient wears a brace or cast for about 12 weeks.
Surgical treatment. Surgery is usually necessary if there is an injury to the posterior (back) ligaments of the spine. Another reason surgery may be needed is if the fracture involves multiple vertebrae.
Fractures Caused by Rotation
Nonsurgical treatment. Transverse process fractures are usually treated with a gradual increase in motion, with or without bracing, based on comfort level.
Surgical treatment. Fracture-dislocations of the thoracic and lumbar spine are caused by very high-energy trauma. They can be extremely unstable injuries that often result in serious spinal cord or nerve damage. These injuries require surgery to stabilize the spine. The ideal timing of surgery can often be complicated. Surgery is sometimes delayed because of other serious, life-threatening injuries.
Surgical Procedure
The ultimate goals of surgery are to:
• Achieve adequate reduction (return the bones into their proper position)
• Stabilize the fracture
• Relieve pressure on the spinal cord and nerves
• Allow for early movement
Depending on the fracture pattern, the doctor may perform the procedure through either an anterior (front), lateral (side), or posterior (back) cut in the skin (incision). Sometimes, the doctor will use a combination of all three incision locations.
There are many types of specialized instruments used in spine surgery. These include metal screws, rods, and cages used to stabilize the spine.