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Central Compression Fracture Of Vertebral Body. Has Diabetes And Hypertension. Cured By Rest And Medication?
Question: Hello Doctor,
My Mom (age 65) fell from bed on 6th Feb and we took her to a doc. Xray, MRI and BMD was done. I dont want to go for any surgery (keyhole or otherwise) and would like to know is the following condition can be cured by rest and medication. She has a known history of diabetes mellitus (glynase mf) and Hypertension ( no medication now). She is also taking ppg 0.3 mg, shelcal. She is allergic to powerful antibiotics/painkillers. Is there any suggestion/medication/ physiotherapy?
She is currently under complete bed rest and just walks to restroom and back. She is using a hyper extension belt while walking. Feels no pain while walking, but unable to sit for more than 10-15 mins. Please suggest.
MRI taken on 10th Feb revealed :
1. Central Compression fracture of D12 vertebral body, Marrow Oedema is noted within D12 vertebral body appearing hypointense on T1 and heterogenously hyperintense on T2 Wt IRFSE images. No evidence of retropulsion.
2. Sacralization of L5 vertebra is noted.
3. Degenerative endplate changes are noted at lower endplates of L3, L4 & upper endplate of L5 vertebral bodies.
4. Forward displacement of L4 over L5 vertebra is noted suggestive of grade 1 Spondylolisthesis. Rest of vertebral bodies and appendages are normal. No evidence of osteosclerosis & spondylolysis.
5. Pseudo-posterior bulge of L4-5 disc indenting the thecal sac, impinging on bilateral exiting L4 nerve roots and compromising the neural foramina.
Thanks
XXXXXXX
My Mom (age 65) fell from bed on 6th Feb and we took her to a doc. Xray, MRI and BMD was done. I dont want to go for any surgery (keyhole or otherwise) and would like to know is the following condition can be cured by rest and medication. She has a known history of diabetes mellitus (glynase mf) and Hypertension ( no medication now). She is also taking ppg 0.3 mg, shelcal. She is allergic to powerful antibiotics/painkillers. Is there any suggestion/medication/ physiotherapy?
She is currently under complete bed rest and just walks to restroom and back. She is using a hyper extension belt while walking. Feels no pain while walking, but unable to sit for more than 10-15 mins. Please suggest.
MRI taken on 10th Feb revealed :
1. Central Compression fracture of D12 vertebral body, Marrow Oedema is noted within D12 vertebral body appearing hypointense on T1 and heterogenously hyperintense on T2 Wt IRFSE images. No evidence of retropulsion.
2. Sacralization of L5 vertebra is noted.
3. Degenerative endplate changes are noted at lower endplates of L3, L4 & upper endplate of L5 vertebral bodies.
4. Forward displacement of L4 over L5 vertebra is noted suggestive of grade 1 Spondylolisthesis. Rest of vertebral bodies and appendages are normal. No evidence of osteosclerosis & spondylolysis.
5. Pseudo-posterior bulge of L4-5 disc indenting the thecal sac, impinging on bilateral exiting L4 nerve roots and compromising the neural foramina.
Thanks
XXXXXXX
Dear XXXXXXX
Thanks for posting your query.
You must have realised your mother has a fracture of spine. She can be treated conservatively if the pain is tolerable and no neurological compromise is noted. She must use a Taylor's brace while walking. Avoid all movements at back with gradual physiotherapy in form of back strengthening exercises.
If she has radiating pain in legs associated with tingling numbness and visible muscular weakness, she has at undergo a decompression surgery. We now have opions of micro surgery done endoscopically.
The location of her fracture is very notorious for nerve and cord complications, so make sure she takes all necessary precautions. Keep pain killers on sos basis.
Don't worry about sacralisation and listhesis now, deal with main issue at hand first.
Hope this answer was informative. If you need more help, I'm available for follow up.
Regards.
Thanks for posting your query.
You must have realised your mother has a fracture of spine. She can be treated conservatively if the pain is tolerable and no neurological compromise is noted. She must use a Taylor's brace while walking. Avoid all movements at back with gradual physiotherapy in form of back strengthening exercises.
If she has radiating pain in legs associated with tingling numbness and visible muscular weakness, she has at undergo a decompression surgery. We now have opions of micro surgery done endoscopically.
The location of her fracture is very notorious for nerve and cord complications, so make sure she takes all necessary precautions. Keep pain killers on sos basis.
Don't worry about sacralisation and listhesis now, deal with main issue at hand first.
Hope this answer was informative. If you need more help, I'm available for follow up.
Regards.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hello,
Thanks for posting your query.
The MRI report of your mother is suggestive of compression fracture of D12 vertebra and age related spondylottic and degenerative disc changes in the lumbosacral region.
The cause of fracture of D12 vertebra can be injury or a chronic infection like tuberculosis or bony metastasis.
Whole body scan and blood investigations are needed to find out the cause of compression fracture. The treatment will then depend on the cause. If it is due to the injury and she can carry out her daily functions without much discomfort then surgery is not necessary. The injury is almost two months old. A repeat MRI scan will help in identifying the extent of healing that has taken place.
The degenerative changes if the spine do need pain killers, muscle relaxants and physiotherapy under the guidance of a proficient physiotherapist once the fracture has healed and acute pain subsides.
She needs a thorough evaluation to determine the cause of compression fracture so that treatment can be initiated early.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Thanks for posting your query.
The MRI report of your mother is suggestive of compression fracture of D12 vertebra and age related spondylottic and degenerative disc changes in the lumbosacral region.
The cause of fracture of D12 vertebra can be injury or a chronic infection like tuberculosis or bony metastasis.
Whole body scan and blood investigations are needed to find out the cause of compression fracture. The treatment will then depend on the cause. If it is due to the injury and she can carry out her daily functions without much discomfort then surgery is not necessary. The injury is almost two months old. A repeat MRI scan will help in identifying the extent of healing that has taken place.
The degenerative changes if the spine do need pain killers, muscle relaxants and physiotherapy under the guidance of a proficient physiotherapist once the fracture has healed and acute pain subsides.
She needs a thorough evaluation to determine the cause of compression fracture so that treatment can be initiated early.
I hope this answers your query.
In case you have additional questions or doubts, you can forward them to me, and I shall be glad to help you out.
Please accept my answer in case you do not have further queries.
Wishing you good health.
Regards.
Dr. Praveen Tayal.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Dr XXXXXXX
Thanks for the clarification. Sure, i do understand that her spine is fractured. As of now, she has bit of pain in her legs as well, but not continuously. I will try with the Taylor's brace and also check with the nearest Ortho again.
Thanks
XXXXXXX
Thanks for the clarification. Sure, i do understand that her spine is fractured. As of now, she has bit of pain in her legs as well, but not continuously. I will try with the Taylor's brace and also check with the nearest Ortho again.
Thanks
XXXXXXX
You are most welcome sir.
Good luck
Good luck
Note: For further queries, consult a joint and bone specialist, an Orthopaedic surgeon. Book a Call now.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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