A spinal injury is an injury to the soft tissues in the region of the spinal column.. It can occur due to a fall on your back or a blow, during a traffic accident, sports, industrial or natural disasters..

When a bruise occurs, trauma to the soft tissues in the region of the spine The share of spinal injuries accounts for 3 to 5% of cases of all closed injuries and 5–17% of all injuries of the musculoskeletal system. In more than half of the cases, spinal cord injury (SCI) is combined with damage to other organs and tissues. Bruises can occur in people of any age and gender, more often in children, men of working age and the elderly.

The bruise is manifested by pain syndrome, swelling and restriction of movement. In mild cases, only the soft tissues of the back are damaged, in severe cases, contusion of the spinal cord may be observed in combination with neurological symptoms..

Causes of spinal bruises Most often, PSCI occurs when falling on your back when slipping on a smooth surface or when practicing traumatic sports.

Spinal injuries occur due to a fall on the back Damage to the cervical spine is often noted as a result of the so-called whiplash injury - a sharp movement of the head forward or backward during an accident during emergency braking of the car. Thoracic and lumbar injuries are less common in road traffic accidents.

Injuries to the cervical spine are often associated with whiplash. Also, SITI often occurs during recreation on the water.. When hitting the head on the surface of the water or the bottom, the cervical region is usually damaged, when falling flat on the water, the thoracic and lumbar regions.

Classification of bruises of the spine According to the severity of bruising of the spine can be:.

Severity.

Description.

Light.

Only soft tissues are damaged, including skin, muscles, subcutaneous fat. Neurological symptoms do not develop.

Medium.

The injury is accompanied by a concussion of the spinal cord. There are transient neurologic deficits that usually resolve within a few hours to 2–3 weeks..

heavy.

Spinal cord injury occurs. Functional pathological changes are observed in combination with pathomorphological disorders in the form of hemorrhage in the tissue of the spinal cord, formation of foci of necrosis. Significant neurologic symptoms are characteristic. The average recovery time is in the range of 3-5 weeks. Possible consequences: paresis, areflexia, sensory disturbances, etc..

According to the terms, PSMT is divided into periods:.

acute: first 3 days;

early: interval from 3 days to 3-4 weeks;

intermediate: interval from 1 to 3 months;

late: more than 3 months.

According to the type of damage, in addition to bruises, PSCI can take the form of a fracture, dislocation, self-adjusted dislocation, fracture-dislocation of the vertebrae, spondyloptosis, partial / complete rupture of the capsular-ligamentous apparatus of the vertebral motor segment, rupture of the intervertebral disc.

Other types of classification:.

nature of the spinal cord injury: SCI may be complicated or uncomplicated (with or without damage to the spinal cord and spinal nerves);

localization: a contusion can affect the cervical, thoracic, lumbar and sacral regions, multiple multi-level injuries of the spinal column or multiple or multi-level spinal injuries are possible;

the degree of violation of the integrity of the covers: PSMT can be closed, open and penetrating.

If a traumatic bruise is combined with a fracture of the spinal column, this type of PSCI is one of the serious lesions.. According to the mechanism of formation, fractures are divided into compression, distraction and rotational..

Symptoms of spinal injury Injury is manifested by the following symptoms:.

local pain syndrome;

antalgic reflex muscle contraction;

restriction / impossibility of movements in the spine;

change in the axis of the spine, sometimes there is a kyphotic deformity in the area of \u200b\u200bdamage;

bruising, swelling, wounds and abrasions of soft tissues.

The site of damage usually hurts locally. Neurological disorders are possible in the form of a violation of sensitivity, motor function, function of the pelvic organs below the level of damage, etc..

Without damage to the spinal cord, the contusion is manifested by back pain, which is aggravated by active movements, standing and walking. No breath holding at the time of injury.

Examination reveals local swelling, redness, or bluishness. In some cases, hematoma formation occurs. Muscle tension can be determined by palpation.

Pressure on the spinous processes is painless or accompanied by minor soreness due to damage to the superficial soft tissues.

With spinal cord injury This type of injury is characterized by sharp pain at the time of injury.. The severity of neurological disorders is determined by the localization of the damaged area.

If the vertebrae of the cervical region are bruised, symptoms such as ptosis, pathological dryness of the face and constriction of the pupils may appear.. If the brainstem is involved, there may be cardiac and respiratory disturbances, including difficulty breathing or forced breathing, which involves the muscles of the neck, chest and back.

Injury can be manifested by paralysis of the upper, lower or all four limbs.. Reflexes are reduced or absent. In severe spinal injuries, respiratory arrest and death can occur..

With a bruise of the lumbar spine, flaccid paralysis of certain sections of the lower extremities or sensitivity disorders, dysfunction of the pelvic organs can be observed.

First Aid Pre-hospital spinal bruising is difficult to differentiate from more severe injuries, including unstable fractures. In this regard, when providing first aid, one should proceed from the fact that any movement can cause a deterioration in the condition and lead to an aggravation of neurological symptoms..

First aid requires immobilization All patients with suspected spinal injury (including those who are unconscious after being beaten, traffic accidents, falls from a height, diving in shallow water) should be immobilized at the scene of detection. The most effective is the combination of a rigid head holder with a rigid shield under the back with the victim fastened with belts..

Until proven otherwise, the patient is considered to have a damaged spine.. It is categorically impossible to roughly move him, put him on his feet, ask him to bend his torso, sit down, etc..

DiagnosisTo make a diagnosis, it is necessary to find out the mechanism of injury, the symptoms that arose immediately at the time of injury.. On examination, complaints of pain in the area of \u200b\u200bspinal injury, sensory and motor disorders, dysfunction of the pelvic organs are evaluated..

To clarify the diagnosis, computed or magnetic resonance imaging is prescribed. The main diagnostic measures include:.

X-ray of the spine in direct and lateral projection;

computed or magnetic resonance imaging;

general and biochemical blood test;

general urine analysis;

ECG;

coagulogram;

Ultrasound and radiography of the abdominal organs.

It is necessary to consult a therapist, surgeon, traumatologist, according to indications, an examination by a doctor of a different profile may be required.

Treatment of spinal injury The goal of therapy is:.

fixation and stabilization of spinal motion segments for early rehabilitation;

decompression of the spinal cord and its roots.

Pain relief and antibiotic prophylaxis are usually prescribed.. Also, depending on the indications, the following is carried out:.

correction of microcirculation disorders: Pentoxifylline;

stimulation of synaptic transmission of nerve impulses: Galantamine;

relief of spastic syndrome in central paralysis and paresis: Baclofen.

Non-drug therapyIn the first three days, bed rest is recommended. If there are no gross neurological disorders, after this period, you can walk with the help of a walker.. You can only get up in a removable hard corset. Depending on the severity of the injury, it must be worn for up to 6 months.

In the presence of a gross neurological deficit, the victim should lie on an anti-decubitus mattress. Starting from the first day of bed rest, every 2 hours it should be actively rotated in bed (from the back to the stomach and to the side), you can give the body a semi-vertical position.

To speed up recovery, physiotherapy is indicated. It is necessary to start conducting physiotherapy exercises in the early stages - from the second day after an uncomplicated bruise. You should also pay attention to breathing exercises, which is the prevention of hypostatic pneumonia..

Physiotherapy is indicated starting from the 2nd-4th day. It may include massage, magnetotherapy, electrophoresis, ultrasound, laser therapy, UHF therapy, etc..

Evaluation of the effectiveness of treatmentThe effectiveness of the treatment is evaluated based on the following criteria:.

reliable stabilization of spinal motion segments, elimination of compression factors of spinal canal structures;

no complications, including bedsores, pneumonia, uroinfections, gastrointestinal bleeding, etc..

Consequences The outcome of the injury has a wide variability: from complete recovery to disability.

Often after spinal injuries, chronic pain is observed, the risk of secondary pathologies increases, including deep vein thrombosis, urinary tract infections, pressure ulcers and respiratory complications..

The functional consequences of a spinal injury depend on many factors: the nature and degree of injury, the adequacy and timeliness of first aid, treatment and rehabilitation measures..

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