Fracturas por compresión
Compression Fractures refer to the collapse of vertebra. The fractures are due to weakening of the vertebra or trauma. The weakening is mostly experienced by individuals who are suffering from osteoporosis or osteogenesis imperfecta, infection, or lytic lesions resulting from primary or metastatic tumors.
In healthy people, this condition occurs as a result of extreme vertical shock such as when a pilot ejects from the plane on an ejection seat.
Síntomas
Compression fractures might occur suddenly and this can result in severe back pain. The pain experienced is in most cases in mid lower spine and will be felt in the front or in the sides of the spine.
The pain has been described by patients as being knife-like and sharp. This pain is in most cases disabling and may take a few weeks and sometimes months to go away.
When the compression fractures are caused by osteoporosis, the symptoms will not appear immediately. These fractures are discovered in some cases when the patient has x-rays done for a different reason.
With time, the following symptoms may appear:
> Pérdida de estatura: algunos pacientes llegan a perder hasta 15 cm.
> Joroba de viuda, que es una cifosis o postura encorvada.
> Dolor de espalda que comienza gradualmente y se agrava al caminar y no está presente al descansar.
En raras ocasiones, la postura encorvada puede provocar debilidad, dificultad para caminar, pérdida de la vejiga y el intestino y sensaciones de hormigueo y entumecimiento.
Causas
Osteoorosis has been named as one of the major causes of compression fractures. Osteoporosis refers to an illness where the bones turn fragile as a result of lack of minerals such as calcium.
Other causes include trauma of the back, tumors that started in the spine like myeloma, tumors that started in the bone or from anywhere else and spread to the bone.
Multiple fractures can lead to kyphosis which is the hump-like curve of the spine leading to an altered posture that might result in further complications and pain.
Most people experience their first acute low back pain when they are between the age of 20 and 40 years old. This is the first reason why most people see a medical professional in adulthood.
In most case there are recurrent pain episodes and in more than 50% of the people, the following episodes are more painful than the first one. There are other problems that might emanate from low back pain.
People suffering from chronic low back pain might experience sleep problems such as disturbances during sleep, less sleep satisfaction, short sleep durations and a great amount of time required to fall asleep. A large number of people suffering from chronic LBP will also show anxiety or depression symptoms.
Diagnóstico
A medical practitioner will perform a physical examination which might show the tenderness on the affected bones and spinal bones, humpback or kyphosis. An x-ray will reveal at least one compressed vertebra which will be shorter than other vertebrae or shorter than it should be.
Other test might include bone density to evaluate the possibility of osteoporosis, and MRI or CT scan in situations where the cause of the fracture is suspected to be trauma or a tumor.
Tratamiento
La mayoría de las fracturas por compresión se producen en personas mayores con osteoporosis y no dañan la médula espinal. Esta enfermedad se trata fácilmente con suplementos de calcio y medicamentos para prevenir nuevas fracturas. El dolor se controla con analgésicos o un simple reposo en cama.
Other treatment options might include back braces but these are known to weaken the bones and lead to more fractures, physical therapy to strengthen the muscles around the spine and medication to relieve the pain.
Surgery becomes an option where other medications fail and the pain persists for more than two months. The surgeries performed are vertebroplasty, spinal fusion and balloon kyphoplasty.
