Backbone bruise – a trauma of soft fabrics in a zone of a spine column and okolopozvonochny area. Can result from falling on a back or blow in a back in life, during sports activities, the road accident, natural or industrial disaster. It is shown by pain, a swelling and restriction of movements. In mild cases only soft tissues of a back suffer, at heavy damages the contusion of a spinal cord with development of neurologic symptomatology is possible. For specification of the diagnosis use a X-ray analysis, a miyelografiya, MPT, KT and other researches. Treatment is conservative.
Backbone bruise – a spine injury at which the soft fabrics surrounding a spine column suffer. The majority of bruises lungs, neurologic symptomatology does not come to light. At heavy bruises of a backbone the concussion or a bruise of a spinal cord which are followed by passing neurologic violations can be observed. Damages can arise at persons of any age and a floor, however the children, young people leading active lifestyle and men of working-age suffer more often. Treatment of not complicated bruises of a backbone is carried out by experts in the field of traumatology and orthopedics. At the complicated bruises (with neurologic symptomatology) the help of the neurologist or neurosurgeon is required.
Reasons of bruises of a backbone
Bruises of a backbone can arise when falling on a back: on the street during ice, at a podskalzyvaniye on a firm smooth surface (for example, in a bathroom or in the administration premise with marble floors) at occupations skating, alpine skiing and other sports, influence of a blast wave, a blockage in the mine, a blockage at a collapse of the residential building during an earthquake etc.
The reason of a bruise of cervical department it becomes frequent a so-called hlystovy trauma – the sharp movement by the head forward or back at emergency brake application of the car during road accident. Less often at road incidents there are injuries of chest and lumbar department of a backbone. Besides, bruises of a backbone are often formed during rest on water. The victim or dives into water headfirst and hits against a bottom or against water, damaging cervical department, or falls on water flatwise and injures chest and lumbar departments.
Classification of bruises of a backbone
Allocate three degrees of a bruise of a backbone:
- Slight injury of a backbone. Only superficially located soft fabrics (skin, muscles, hypodermic fatty cellulose) suffer. Neurologic symptoms are absent.
- Bruise of a backbone of average weight. Is followed by concussion of a spinal cord. Pathological changes are caused by ultraboundary braking of conductivity on nervous fibers. The passing neurologic violations disappearing in time from several hours to 2-3 weeks are observed.
- Heavy bruise of a backbone. Is followed by a bruise of a spinal cord. Functional pathological changes are combined with patomorfologichesky violations (hemorrhages in tissue of a spinal cord, formation of the centers of a necrosis). The neurologic symptomatology is expressed more brightly, than at concussion, the term of restoration fluctuates from 3 to 4-5 weeks. The residual phenomena are possible (paresis, sensitivity violations, an arefleksiya, hypo - or a hyper reflection etc.).
Backbone bruise without injury of a spinal cord
The breath delay at the time of a trauma is absent. The patient with a bruise of a backbone is disturbed by the back pains amplifying at the active movements, standing and walking. At survey local hypostasis, redness or cyanosis comes to light. Hematomas are sometimes formed. Palpatorno is defined tension of muscles and local morbidity in the field of a bruise. Pressure upon awned shoots without serious consequences or is followed by the insignificant morbidity caused by damage of surface soft fabrics.
For an exception of spinal fracture appoint a X-ray analysis. In doubtful cases in addition use KT of a backbone or MRT. At suspicion on insignificant neurologic violations of the patient direct to survey to the neuropathologist or the neurosurgeon. Treatment is carried out by the traumatologist in emergency station. Recommend to the patient a bed rest. For unloading of a backbone it is better to sleep on a rigid surface (it is possible to enclose a wooden board under a mattress) with the roller under area of a waist.
To a defeat zone in the first days advise to put cold unless the bruise settles down in a kidney projection. In the subsequent appoint UVCh, recommend to put dry heat to area of a bruise, to use the rassasyvayushchy and warming ointments. The outcome is usually favorable, all symptoms of a bruise disappear within several weeks. Development of post-traumatic osteochondrosis is in some cases possible.
Backbone bruise with injury of a spinal cord
Such bruises arise at high-energy injuries more often (falling from height, road accident, blockages, a diving headfirst etc.). At the time of damage sharp pain develops. The nature of neurologic violations depends on localization of a bruise. At bruises of cervical department narrowing of pupils and pathological dryness of the person can come to light . In some cases (when involving in process of a trunk of a brain) violations of warm activity, violation of swallowing and a hiccups are observed.
Respiratory frustration are possible: difficulties of breath or the forced breath with use of muscles of a neck, breast and back. At heavy bruises of a spinal cord respiratory standstill and death develops. Depending on weight of an injury of spinal cord the tetraplegiya, tetraparesis or easy weakness in extremities in combination with sensitivity violations can be observed. At damage of the top cervical vertebras there is spastic paralysis of all four extremities, at defeat of lower – spastic paralysis of the lower extremities and sluggish – top. Reflexes are lowered or are absent.
Bruises of chest department of a backbone with concussion or a bruise of a spinal cord are shown by violations of sensitivity on conduction type in combination with paralysis, paresis or weakness of the lower extremities. Belly reflexes decrease or disappear. Kardialgiya are possible. There are malfunction of pelvic bodies of various degree of expressiveness. Bruises of lumbar department of a backbone are followed by sluggish paralysis of certain sites of the lower extremities and violations of sensitivity (the upper bound of motive violations and violations of sensitivity depends on the level of damage of a spinal cord). Dysfunctions of pelvic bodies can be observed. Early development of decubituses is characteristic. Often there is cystitis.
At a pre-hospital stage the bruise of a backbone cannot be differentiated from heavier damages, including – from unstable spinal fractures. Therefore at first-aid treatment it is necessary to recognize that any movement can lead to deterioration in a condition of the victim and aggravation of neurologic symptomatology. The patient cannot be put on legs at all, to ask to sit down, roughly to move, bend a trunk etc.
If when transporting there is an opportunity to lay the victim on a firm surface (for example, on a wooden board or the door removed from loops), it should be moved and put accurately there on a back, trying to disturb as little as possible a backbone. If from make-shifts of transportation only a stretcher is available, stacks the patient on a stomach, having tried to level previously a surface of a stretcher blankets or the curtailed clothes. At the same time it is necessary to watch that the back of the victim remained unbent.
The patient shift to a stretcher or a board three together, at the same time holding him for the head, a breast, a waist, area of a basin and area of knee joints, and then tie to means of transportation, using wide belts or tapes. Before movement to the victim inject the anesthetizing drugs. At damage of cervical department immobilize a neck, using a special collar or the dense fabric curtailed into several layers.
After holding these actions of the patient urgently bring to traumatologic, nervous or neurosurgical office for further inspection and treatment. The plan of inspection includes a backbone X-ray analysis, detailed neurologic survey, a spinal puncture, backbone MRT, a miyelografiya and other researches. Treatment is carried out in the conditions of a hospital.
The patient is stacked on a bed with a board. For improvement of blood supply and stimulation of neurons appoint methylprednisolonum. Apply the anesthetizing medicines, diazepam, and vitamin E. Use physiotherapeutic procedures and LFK. Carry out actions for prevention of decubituses and infectious defeats of urinogenital system. Upon termination of the sharp period hold rehabilitation events, in need of patients send to the specialized centers and sanatoria.
At concussions of a spinal cord the absolute recovery becomes an outcome. In case of a bruise the forecast less favorable – at insignificant damages of violation of movements and sensitivity disappear within 4-5 weeks, but the rehabilitation period can occupy before half a year and more. In the remote period after heavy bruises the residual phenomena (paralyzes, paresis, sensitivity losses) can remain during all life.