FRACTURE AND SPRAIN

  • Definition and cause


    Fracture or compression of a vertebra usually corresponds to a collapse of the front part of the vertebra (the vertebral body). The vertebral body is like a box and its fracture, depending on the severity, may mean a simple depression of its lid (the vertebral endplate) with a low risk of progression, or a collapse of all of the walls of the box, making the whole vertebra very unstable. It is in this second type of fracture that the spinal cord, which passes just behind the vertebral body, can be affected, resulting in paralysis. In the cervical (neck) region, sprains are more common than fractures. In severe sprains, there can be a progressive slipping of a vertebra on the one below it. In the elderly, vertebral compressions occur much more frequently, and are only the consequence of a significant bone fragility (osteoporosis).



  • Course of the disease


    In case of significant spinal trauma, the presence (even partial) of paralysis, numbness or tingling in the limbs must lead to urgent consultation with a spinal surgeon..
    A vertebral fracture consolidates in 3 months. Simple sprains of the cervical spine heal in 2 to 3 weeks, but sometimes the pain persists for several months. Severe sprains are as severe as a fracture and require surgery.



  • Treatment options


    According to the type and severity of the fracture, treatment will be either immobilization by a back brace (or a neck brace for the neck), an injection of cement into the vertebra (cementoplasty) to strengthen it, or surgery to stabilize the vertebra by means of metal implants (osteosynthesis).



  • Principle of surgical treatment


    In the back, unstable fractures (i.e., those that threaten the spinal cord) absolutely must undergo surgery to be stabilized. The surgery is most often done through the back, and involves placement of an implant system comprised of screws and rods, which will make it possible to correct the compression of the vertebra, by straightening it and supporting it during its consolidation. In the neck, unstable fractures and severe sprains must also undergo surgery for the same reasons. In this case, the surgery is most often done through the neck, and involves replacing a disc or a vertebra with an implant or a bone graft, all of which is also stabilized by a vertebra fixation system (osteosynthesis)


  • Average hospitalization time


    Average hospitalization time For simply providing a back brace (custom, suitable plastic, removable), hospitalization will last for the time of fitting, delivery and adjustment of the back brace, i.e., 24 to 48 hours. In case of cementoplasty, discharge will take place the day after the procedure. After surgery, discharge will take place after 3 to 7 days. (these are the durations most often reported)



  • Recovery time


    Recovery time A 3-month recovery period is essential following the surgery. Based on the type of fracture and the severity of symptoms before the procedure, this period may be longer. Recovery is not synonymous with bed rest. Physical exertion, carrying loads, and car trips must be limited during this period. Walking is often beneficial. Recurrence of pain during recovery is often the result of too much activity and will tend to disappear with rest.