Spine Fracture, Lower Thoracic & Lumber Region

A complete or incomplete break in a bone in the lower thoracic or the lumbar spine. The lowest part of the thoracic spine and the first two bones of the lumbar spine are the most common sites for fractures in this region. This is due to the change in the spine's curvature and the lack of rib-cage support.

Body Parts Involved

• Bones of the lower thoracic and lumbar spine.
• Joints between segments of the spine.
• Soft tissue around the fracture site, including muscles, nerves, tendons, ligaments, periosteum (covering to bone), blood vessels and connective tissue.

Causes

Direct blow or indirect stress to the bone. Indirect stress can be excessive spinal flexing, extension, rotation or bending. Common situations that cause this fracture include:

• A hard fall in which the person lands on the heels.
• Sitting down hard, especially for an older person with osteoporosis.
• A heavy load falling on a bent back, such as someone jumping on a swimmer's back

Signs & Symptoms

• Severe pain in the spine.
• Swelling and bruising around the fracture.
• Visible deformity if the fracture is complete and the bone fragments separate enough to distort normal back contours.
• Tenderness to the touch.
• Paralysis of legs and muscles in the pelvis, if the spinal cord is injured.

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

• Cut away clothing, if possible, but don't move the injured area to do so.
• Use a spineboard to immobilize the back while transporting the injured person to an facility.
• Elevate the injured part above the level of the heart to reduce swelling and prevent of excess fluid. To do so, elevate the foot of the spineboard or the bed.
• keep the patient warm with blankets to possibility of shock.
• Treatment consists of surgically or non-surgically realigning and holding the spine in its correct position. Realignment should be done as soon as possible after injury. Six or more hours after the fracture, bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and to return to a normal position.

Continuing Care

• Immobilization will be necessary. This may mean immobilization of the patient with bed rest in a rehabilitation facility, or immobilization of the fractured bones with internal wires or screws. A cast is rarely used.
• After treatment, use ice massage if possible. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day.
• After 72 hours, you may apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers or heating pads.
• Take whirlpool treatments, if available.
• Massage gently and often to provide comfort and decrease swelling.

Medication

Your doctor may prescribe:

• General anesthesia, local anesthesia or muscle relaxants to make bone manipulation possible.
• Narcotic or synthetic narcotic pain relievers for severe pain.
• Stool softeners to prevent constipation due to inactivity.
• Acetaminophen (available without prescription) for mild pain after initial treatment.
• Antibiotics to fight infection if the skin is broken or surgery is needed.

Home Diet

• Drink only water before manipulation or surgery to treat the fracture. Solid food in your stomach makes vomiting while under anesthesia more hazardous.
• During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation.
  

Diagnostic Measures

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• X-rays of the underlying area to rule out fractures and joint damage.

Prevention Tips

• Build your strength with a good conditioning program before beginning regular athletic practice or competition. Increased muscle mass helps protect bones and underlying tissue.
• Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk product calcium supplements.