A bruise is a lesion of tissue of a traumatic nature, the main distinguishing feature of which is the absence of a violation of the integrity of an organ or tissue.
Behind such a prosaic definition is a common trauma in everyday life.
According to medical statistics, bruises account for at least 80% of all traumatic injuries.
For the most part, a bruise passes without significant consequences for a person and does not present a danger to life and health.
If we talk about spinal injuries, they can not be called light, even if we are talking about bruises. Such injuries should be taken seriously, both to the patient and to the treating specialist.
The reason for the danger of spinal injury is the functional role of the spinal column, as well as the complexity and fragility of its structure. In addition to the main supporting function, the axial skeleton performs the function of protecting the spinal cord. Often with spinal injuries, damage to the spinal cord occurs, and the danger of such injuries does not need to be explained: paresis, paralysis, other sensory impairments, these are the direct consequences of spinal cord disturbances.
So, a spinal injury is a damage to the spinal column of a mechanical nature, which preserves the integrity of the structures of the spine and spinal cord.
Spinal injury: causes
The spine is "covered" with a powerful muscle corset, so under normal conditions getting a bruise is quite difficult.
In more than half of all cases of seeking specialized care, a spinal injury was received as a result of a traffic accident (about 70% of all cases).
However, in the remaining cases, the reasons were different, among them:
• Domestic fights, unsuccessful sparring.
• Falling from a height (or jumping).
• Water strike when diving.
• A longitudinal blow to the spine with a blunt object (with transverse impacts, fractures are more common).
• Violation of the technique for performing sports exercises.
• Falling on the back (with fainting, epileptic seizure, etc.).
• Other falls in domestic conditions (from a bed, from a chair).
This injury is relatively rare: no more than 9-10% of all cases. The risk group includes men of working age engaged in heavy physical labor, as well as athletes of both sexes. Paradoxically, children, despite a high level of physical activity and older people suffering from a weakened muscle corset, are prone to bruises of the spine much less.
Due to the structural features of the skeleton, ladies are more susceptible to spinal cord injuries, therefore females should at least carefully take care of the safety of their spine.
Spinal injury: symptoms
Symptoms of a bruised spine are very specific. The specific symptomatology depends on the severity of the injury, as well as its location.
Based on these two criteria, spinal bruises are divided as follows.
By location of damage:
• Injuries to the cervical spine.
• Injuries to the thoracic spine.
• Bruises of the lumbar spine.
• Injuries to the sacrum and tailbone.
By severity:
• Bruises are easy to degree. Neurological symptoms are absent or present to a minimum. The recovery period is from 40 to 47 days.
• Medium bruises. Neurological symptoms are expressed, there is a violation of the innervation of one or more organs. The duration of recovery is about 4 months.
• Severe injuries. Neurological symptoms expressed. There are violations in the work of individual organs or systems, paresis and paralysis are possible. The recovery period lasts about six months.
Accordingly, the symptomatology is characteristic for one degree or another of a lesion of one or another part of the spine.
1) "Universal" and the most common symptom of a bruised spine is pain. The intensity of the pain is strictly individual and cannot be an indicator of the severity of the injury, this should be borne in mind by patients.
2) Often a bruise is accompanied by numbness or tingling at the site of the bruise, or in the region of the limbs. There is a feeling of "leakage", the difficulty of controlling motor activity.
Traumatic lesion of the cervical spine
Bruises of any severity localized in the neck are highly dangerous. Injuries to the cervical spine are usually unstable and often lead to disability in the absence of competent and timely treatment.
Symptoms:
• Pain in the neck and neck (resulting from damage to nerve roots). Pain, as a rule, is dull, monotonous. May be pulsating, burning.
• Violations of the extremities. Since innervation is disturbed, it is possible to develop paresis and even paralysis of one or several limbs.
• Respiratory problems. As a result of damage to the sympathetic nervous system, respiratory failure, up to its cessation, is possible.
• Decreased muscle reflexes. It also occurs due to a violation of innervation.
• Violation of the reaction of the pupils.
• Confusion.
• Ringing or buzzing in the ears.
• Visual disturbances (simplest visual hallucinations - photopsies, loss of visual fields, decreased visual acuity).
• Lack of coordination, staggering gait.
The last 4 symptoms are associated with the development of a hematoma at the site of the bruise, which compresses the arteries that feed the brain. The so-called vertebrobasilar insufficiency. This is a dangerous consequence of neck injuries that can lead to a stroke.
Thoracic trauma
Less dangerous, but also require competent treatment and rehabilitation.
Symptoms
• Decreased libido.
• Decreased coordination.
• Pain in the chest during movement or deep breathing.
• Decreased sensitivity at the site of injury.
• Disorders of the excretory system (fecal and urinary incontinence).
Traumatic lesion of the lumbar
Symptoms are pronounced in any degree of damage:
• Decrease in sensitivity of legs (as a result of disturbance of innervation).
• Decrease in libido (up to a complete absence).
• Disorders from the excretory system (more common than with injuries of the thoracic spine).
• Numbness of the lower extremities, sensation of cold.
• Absence or decrease in tendon reflex.
Traumatic injury to the tailbone or sacrum
• Pain during urination or defecation.
• The occurrence of obvious edema and hematoma at the site of the bruise.
• Strengthening pain during palpation of the bruise.
• Decreased motor activity of the legs.
Spinal Injury: Diagnosis
Diagnostic measures are standard not only for bruises, but also for any spinal injuries. Injury of the spine - the damage is serious and requires contacting not one, but several specialists at once. Among them:
• Surgeon (or neurosurgeon)
• Orthopedist, traumatologist
• Neurologist
Diagnostic measures include:
• History taking (nature of pain, their localization, under what conditions the injury was received, how long, etc.). Clarifying questions allow you to create a primary idea of the nature and severity of the damage.
• Inspection. It consists in a visual assessment of the damaged area. Often with bruises of the spine, edema, swelling at the site of damage, and discoloration of the skin are detected.
• Palpation. It allows you to evaluate the intensity of the pain syndrome, to determine the degree of muscle tension. Palpation is also necessary to exclude more severe injuries in which deformation of the spinal column and vertebrae occurs.
• Specialized neurological examination. Its essence is familiar to everyone since childhood: a hammer and a doctor’s team. This examination is aimed at assessing the simplest reflexes of the body. Thanks to him, one can assess the degree of neurological deficit.
• X-ray examination. It is aimed at the exclusion of complete and partial fractures of the spine.
• Magnetic resonance imaging (MRI). One of the most informative studies of the spine. In contrast to CT, it is primarily intended for assessing the state of soft tissues and other non-bone structures. Allows you to detect damage to the spinal cord, blood vessels, etc.
• CT (computed tomography). It is aimed at identifying disorders of the bone structures of the spine.
• Spinal puncture. It is relatively rarely used in diagnostics in view of its danger. It is used for confirmed damage to the spinal cord.
Spinal Injury: Treatment
The treatment of spinal injuries is a difficult task and does not forgive the amateurish attitude.
Treatment can be divided into two stages:
• Removal of pain and neurological symptoms.
• Restoring the functions of the damaged area of the spine (rehabilitation).
Removing pain and neurological symptoms with spinal injuries requires the use of anti-inflammatory drugs (Pentalgin, Diclofenac, etc.) in the form of tablets or ointments.
Often used combinations with strong hormonal drugs (prednisone, dexamethasone, etc.). However, it is not recommended to use these drugs on their own, as they have dangerous side effects.
At the second stage, physiotherapy (electrophoresis, magnet) and exercise therapy is prescribed.
The specific strategy depends on the severity of the lesion and the presence or absence of concomitant diseases of the musculoskeletal system. In any case, in no case can one rely on "maybe." Bruising of the spine requires qualified medical attention.
Spinal Injury: Prevention
In most cases, spinal injuries can be avoided with caution.
• When practicing sports, observe the performance technique, use special protective equipment.
• Be careful in everyday life and avoid falling onto your back.
• Be careful on the road.
• Exclude extreme sports.
Thus, a spinal injury is by no means a harmless injury.
In most cases, it can lead a person to disastrous consequences with disability and severe neurological deficit. To avoid a bruise - it is enough to behave carefully in everyday life, but if you still get an injury, you can’t do without medical help.
