Spine Fracture, Sacrum

A complete or incomplete break in the sacrum. This is a serious injury because it frequently damages important nerves that supply the rectum, bladder and genitals. Signs of the nerve damage may not appear for several days after injury.

Body Parts Involved

• Sacrum.
• Lumbo-sacral and sacroiliac joints.
• Soft tissue around the fracture site, including muscles, nerves tendons, ligaments, periosteum (covering to bone), blood vessels and connective tissue.

Causes

• Direct blow to the lower back.
• Indirect stress caused by twisting or other injury to the low back.

Signs & Symptoms

• Severe pain in the lower spine.
• Swelling and bruising of soft tissue 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.
• Numbness beyond the fracture site(sometimes).

Treatment

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

First Aid

• Use a spineboard to immobilize the back while transporting the injured person to an emergency facility
• Keep the person warm with blankets to decrease the possibility of shock.
• The doctor may manipulate the broken bones in surgery to return them to their normal position. Manipulation should be done as soon as after injury, particularly if there is evidence of injury to major nerves in the lower-back region. Six or more hours after the fracture, bleeding and displacement of body fluids may lead to shock. Also, many tissues lose their elasticity and become difficult to return to a normal position.

Continuing Care

• Immobilization will be necessary. Non-displaced sacrum fractures usually require a corset. Displaced fractures may require more complicated immobilization.
• 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.
• Apply heat instead of ice if it feels better. Use heat lamps, hot soaks, hot showers, heating pads or whirlpool treatments.
• Massage gently and often to provide comfort and decrease swelling.

Medication

Your doctor may prescribe:

• General anesthesia, local anesthesia or muscle relaxants before joint manipulation.
• Narcotic or synthetic narcotic pain relievers for severe pain.
• Acetaminophen for mild pain.
• Stool softeners to prevent constipation due to inactivity.
• 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 lower back region, including the pelvis and hips.

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.
• Use appropriate protective equipment, such as sacral or "tailbone" pads, when participating in contact sports.
• Ensure an adequate calcium intake (1000mg to 1500mg a day) with milk and milk product calcium supplements.