FRACTURES
Part 3
We continue our discussion of the topic FRACTURES which we started two (2) issues ago.
Fractures Caused by Flexion
Nonsurgical treatment. Most flexion injuries, including stable burst fractures and compression fractures, can be treated without surgery and can sometimes benefit from bracing.
By gradually increasing physical activity and doing rehabilitation exercises, most patients avoid post-injury problems.
Surgical treatment. Surgery is typically required for unstable burst fractures that have: Significant comminution (multiple bone fragments); Severe loss of vertebral body height; Severe deformity, usually in the form of forward bending or angulation at the injury site; Excessive forward bending or angulation at the injury site.
According to experts, an angulated fracture “occurs when a bone breaks, comes out of alignment, and tilts at an angle”; Significant nerve injury due to parts of the vertebral body or disk pinching the spinal cord; and Ligament damage that makes the spine unstable
These fractures should be treated surgically to clear the spinal canal of objects that could be causing compression on the spinal cord, such as bone and/or soft tissue and to stabilize the fracture.
The procedure to decompress the spine (relieve pressure on the spinal cord) is called a laminectomy.
In a laminectomy, the doctor removes the bony arch that forms the backside of the spinal canal (lamina), along with any bone or other structures that are pressing on the spinal cord. This provides more room for the spinal cord.
To perform the laminectomy, your doctor will access your spine with an incision either on your side or on your back. Both approaches allow for safe removal of the structures compressing the spinal cord, while preventing further injury.
After the laminectomy, your doctor will stabilize the fracture by reconstructing the damaged bone or placing screws above and below the fracture.