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  • Auto accident and acute compressed fractures

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    Old 10-02-2015, 07:54 AM   #1
    dv774
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    Auto accident and acute compressed fractures

    I was in a auto accident last week. After a couple of days of severe back pain had a MRI. Findings show:
    Superior endplate compression of T-12 vertebral body
    More pronounced compression of L-1 vertebral body involving loss of at least half of height
    Retropulsion of portion of vertebral body into canal...mainly midline
    Some facet hypertrophy of L4-5 posteriorly causing mild stenosis
    Acute compressions involves edema and superior aspect of T-12 and entire L-1vertebral body
    Bladder is loss 50% of height
    Mild retropulsion of bone into canal at L-1

    I am in such severe pain I cannot sit, stand or walk without screaming. Neurosurgeon put me in brace and mentioned injecting cement into vertebrae. They say edema present indicates injury is acute. Can anyone interpret these findings for me ? Thank you

     
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    Old 10-02-2015, 12:59 PM   #2
    movielover40
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    Re: Auto accident and acute compressed fractures

    So sorry for your accident.

    Have you tried a whirlpool, hot tub, or swimming pool to relieve some of your pain?

    Praying you feel better soon. Always get a 2nd opinion before surgery.

     
    Old 10-02-2015, 01:25 PM   #3
    dv774
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    Re: Auto accident and acute compressed fractures

    Thanks for your suggestions. I am unable to get into a pool or Whirlpool due to the severe excruciating pain I am having. I am in bed due to the pain. Sitting, standing, walking, any movement causes such pain I only get out of pain to go to bathroom. I don't want any surgery. Thanks for your suggestions. The brace I have doesn't even help significantly.

     
    Old 10-02-2015, 07:28 PM   #4
    teteri66
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    Re: Auto accident and acute compressed fractures

    Sorry to hear about your MVA. They can really create havoc with the spine.

    I would suggest you see a fellowship-trained orthopedic spine surgeon (not a regular ortho, but one who treats only necks and backs) for an evaluation.

    Was there anything else in the report? What concerns me and what may be causing your intense pain is the fragment of the vertebra that has lodged in the canal. I do not see how this could be the case without it impacting the nerves, but no nerve compression is mentioned. What specifically are your symptoms?

    It sounds like you are receiving the usual treatment for a compression fracture of the vertebra. A brace is used for a period of time to immobilize the spine to keep you from bending. If it doesn't heal, then a procedure can be tried called a vertebroplasty or kyphoplasty, which is where the cement comes in.

    The report basically indicates that there are two vertebrae that were fractured, with the one at Lumbar 1 being worse than the one at Thoracic 12. The entire vertebra at L1 is compressed so it is now half its original height.

    There is a bit of degenerative arthritic change in the facet joint at the L4-5 segment. I would guess this was there prior to the MVA as it is a "wear and tear" type issue.

    O

    Last edited by teteri66; 10-02-2015 at 07:50 PM.

     
    Old 10-02-2015, 07:57 PM   #5
    teteri66
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    Re: Auto accident and acute compressed fractures

    Also you should avoid bed rest for longer than four days. Beyond that, it results in loss of muscle mass, causes stiffness, etc.

    Be sure to ask the doctor about that bone fragment and whether it is impacting a spinal nerve. Since you are in so much pain it seems likely that it is.

     
    Old 10-03-2015, 10:52 AM   #6
    dv774
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    Re: Auto accident and acute compressed fractures

    Thanks so much for your reply. My main symptom is severe excruciating low back pain. I also have not pooped in over a week. The back pain gets worse when I sit, stand, walk or move. My feet feel numb. I don't even think the brace is helping very much. I have been bedridden since 9/25 due to the pain. I know I need to get up but the pain does not allow me to. My appointment with the neurosurgeon is not until 10/15. What am I supposed to do until then ? I was not given any instructions to do anything but wear the brace when I'm up over 5 minutes. I have been wearing it in bed too and even sleeping in it but was not told to do so. Why is my pain so low and my fractures higher than where my pain is ?

    Following is exactly word for word what my MRI report says.
    Acute compressions are seen. This involves superior aspect of T 12 and entire L1 vertebral body. The bladder is loss 50% of its height. Edema is seen associated with these fractures. This is not causing significant neural impingement. No other significant abnormality is seen.

    Patient has superior endplate compression of the vertebral body. This is associated with some edema is felt to be acute. There is more pronounced compression of the L1 vertebral body, involving of the loss of at least half of the height. There is edema associated with this indicating that it is also acute. There is some retropulsion of a portion of the vertebral body into the canal, mainly in the midline. There is no associate with obvious neural encroachment. No abnormality is noted at L2-3, 3-4, 4-5 or L5-S1. There is some facet hypertrophy at L4-5 posteriorly, causing mild stenosis of the canal. No foraminal encroachment is seen at any level.

    Thanks for your help. I'm so miserable I can't stand myself. The pain has worsened when I attempt to get up, sit, stand or walk !
    What would a orthopedic spine doctor do different than a neurosurgeon. Please help me !!

     
    Old 10-05-2015, 12:19 PM   #7
    teteri66
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    Re: Auto accident and acute compressed fractures

    Did you see the neurosurgeon after the accident or were you treated by the doctor in the ER? As I mentioned earlier, your findings don't really match your symptoms...so that's why I am focusing on the bone fragment that may be lodged in the central canal. But this seems so obvious that I would assume the doctors saw this and felt it wasn't that significant.

    The spinal cord ends right around the L1 segment. Below that level, the nerves bundle together to form what is called the cauda equina. The individual spinal nerves branch off the cauda equina just as they do off the spinal cord, and can be affected by any pressure on the central canal. The lower lumbar nerves, not only innervate the legs but also the bladder and bowel. I would suggest you look up "cauda equina syndrome" and familiarize yourself with the symptoms. I am wondering if your issue with your bowels is a sign that you may be suffering from CES. Do you have a family physician you could call or get in to see quickly? If not, and have you still have a bowel issue you may want to go to the emergency room.

    It may be that the injury at L1 is causing a great deal of inflammation that is pushing into the spinal canal and compressing nerves of the cauda equina.

    Something is causing all your pain...call the neurosurgeon and ask for guidance as to what you should do. Be sure to mention the bowel issue. (Pain meds can cause constipation.)

     
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