spinal contusion - Causes, Symptoms, Diagnosis and Treatment
Bruising spine. - Soft tissue injury in the area of the spine and paravertebral area. It may occur as a result of falling on his back, or kick back in the home, during sports, traffic accident, natural or industrial disaster. It causes pain, swelling and limitation of movement. In mild cases, affected only the soft tissues of the back, with severe injuries possible contusion of the spinal cord with the development of neurological symptoms. To clarify the diagnosis using X-rays, myelography, MRI, CT scans and other tests. Treatment is conservative.
Bruising
spine.spinal injury, in which the affected soft tissue surrounding the spine. Most injuries lungs, neurological symptoms are not detected. In severe spinal injuries can occur concussion or contusion of the spinal cord accompanied by transient neurological disorders. Damage can occur in people of any age and sex, but most often affects children, young people leading an active lifestyle, and men of working age. Treatment of uncomplicated spinal injuries conducted by specialists in the field of traumatology and orthopedics. In complicated injuries (neurological symptoms) need help neurologist or neurosurgeon.
hematoma. Palpable defined muscle tension and local tenderness in the area of injury. The pressure on the spinous processes painless or accompanied by a slight soreness caused by damage to the surface of soft tissue.
To exclude a spinal fracture prescribe X-rays. In doubtful cases, additional use of CT or MRI of the spine. If you suspect a minor neurological disorders the patient is directed to inspection to a neurologist or neurosurgeon. Treatment is carried out traumatologist in the emergency room. Patients are advised to stay in bed. To unload the spine sleep better on a rigid surface (you can put a mattress under a wooden shield) with a roller under the lumbar region.
To the affected area in the first few days are advised to apply cold except when the injury is located in the projection of the kidneys. Subsequently appointed UHF recommend applying to the field of dry heat injury, use absorbable and warming ointment. The outcome is usually favorable, all the injury symptoms disappear within a few weeks. In some cases, may develop post-traumatic osteoarthritis.
ptosis, pupillary constriction and abnormal dryness of the face. In some cases (with involvement of the brain stem) are observed cardiac abnormalities, swallowing difficulties and hiccups.
Possible respiratory disorders: shortness of breath or breathing accelerated with the use of neck muscles, chest and back. In severe injuries of the spinal cord develops respiratory arrest and death. Depending on the severity of spinal cord injury can occur tetraplegia, tetraparesis or light weakness in the limbs, combined with sensitivity disorders. With the defeat of the upper cervical vertebrae occurs spastic paralysis of all four limbs, with the defeat of the lower - spastic paralysis of the lower limbs and sluggish - the top. The reflexes are reduced or absent.
Injuries of the thoracic spine with a concussion or contusion of the spinal cord appear sensitivity disorders on the conductor type, combined with paralysis, paresis or weakness of the lower limbs. Reduce or disappear abdominal reflexes. Cardialgia possible. There are disorders of pelvic organs of varying severity. Injuries of the lumbar spine accompanied by flaccid paralysis of individual sections of the lower limbs and sensory symptoms (upper limit of motor disorders and disorders of sensitivity depends on the level of spinal cord injury). There may be dysfunction of the pelvic organs. Typically the early development of pressure ulcers. Often there are cystitis.
In the pre-hospital stage injury of the spine can not be differentiated from more serious injuries, including - of unstable fractures of the spine. Therefore, when first aid is necessary to proceed from the fact that any movement can lead to a deterioration of the victim and the worsening of neurological symptoms. The patient is in any case can not be put on its feet, ask to sit down, move roughly, bend the torso and so on. D.
If transportation is possible to turn patient on a hard surface (such as a wooden shield or removed from door hinge), it should be gently moved back and put on his back, trying to disturb as little as possible to the spine. If improvised stretcher transport only available, the patient is placed on his stomach, trying to pre-align the surface of the stretcher folded blankets or clothing. In this case you need to make sure that the back of the victim remained straightened.
Sick shift on a stretcher or a shield-way, while holding his head, chest, lower back, pelvis and the knee, and then tied to a means of transport, using wide belts or bands. Before moving to the victim administered painkillers. If the damage of the cervical immobilize the neck, using a special collar or a thick cloth, folded in several layers.
Following these events the patient urgently taken to the trauma, nervous or neurosurgical department for further examination and treatment. survey plan includes X-rays of the spine, a detailed neurological examination, spinal tap, MRI of the spine, myelography and other studies. Treatment is carried out in a hospital environment.
The patient is placed on a bed with a shield. To improve blood circulation and stimulation of neurons prescribed methylprednisolone. Apply painkillers, Relanium, phenytoin and vitamin E. Use physiotherapy and exercise therapy. To carry out measures for the prevention of pressure sores and infectious lesions of the urogenital system. At the end of the acute period of rehabilitation measures carried out, if necessary, patients are referred to specialized centers and sanatoriums.
When it is shaken spinal cord outcome becomes a complete recovery. In the case of injury prognosis less favorable - for minor injuries and movement disorders sensitivity disappear within 4-5 weeks, but the rehabilitation period can take up to six months or more. In the late period after serious injuries residual symptoms (paralysis, paresis, sensory loss) can persist throughout life.