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Fractured Vertebrae

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What thats crazy Mizu!!!

And to think how much that little snip will save them possibly in the long run!

 

Hello

Jeremy gave me the heads up on this. I am a Chiropractor in Canada and i have been practising for 13 years.

You have a sustained a compression fracture with an anterior step component (the peice you can see that seperated). This is an anterior injury which is definitely better than a posterior injury because the spinal cord is back there.

Basically the spine compressed so hard that the force cause the disc (the cushions between the bones that don’t show up on xrays) to break off a piece of the bone. The discs are actually tougher than bone regarding compressive force) because they have a gel center that cannot be compressed. The piece of bone looks like its floating there but its likely still attached to the disc and surroundig structures.

Bone is very vascular and will heal. it will be mishapen but that in and of itself should not be a major issue. What we don’t know is how badly if at all the disc and surrounding soft tissue is damaged. The medical folks have tunnel vision with these kinds of injuries and usually disregard or dont consider the soft tissue consequences. If there was enough force to do that to the bone the soft tissue in the area (muscles, fascia, tendons, ligaments, the posterior joint surfaces, disc annulus etc) could be damaged as well. Some of these tissues have less of a blood supply than the bone so its healing may be compromised or complicated.

Its likely the residual pain you have is either discogenic (from the disc) or other soft tissue. With rehab and time this pain should go away.

You have suffered a structural wound and its likely the biomechanics of your spine its soft tissue components are not working optimally. I would strongly siggest that you consult a sport injury oreinted chiropractor or physio to have your situation assessed as i can really only give generalities without examining you

In general there are 3 components to a healthy spine (or any joint really). the spine consists of almost 100 joints not including the pelvis. The 3 components are alignment strength and flexibillity. The spine can put up with many small to moderate injuries and still work with some degree of dysfunction but generally will worsen over time.

alignment: this is a function of proper muscle tone (meaning they are not weak or majorly imbalanced) and proper joint function.its highly likely that at least some of the joints in your spine are not working properly due to the trauma sustained and the resulting dysfunction and compensation. you may need joint mobilization or manipulation to correct this.

strength: this is a function of structural stabillity (at least temporarily compromised in your case) and muscle integrity. due to the injury and possible subsequent immobilization you may have been advised to undertake, muscle may be compromised or weakened.like any muscle though this strength can be regained by exercise/training. if you have permanent structural instabillity that will have to be managed but usually this is not the case. its highly likely your body will heal and regain its integity but may not have optimal function.

flexibillity: very few humans have the flexibillity they should. you should try to regain what you’ve lost asap. yoga, pilates or just researching back stretches, anything is better than nothing. do as much as you feel comfy with, sharp pains are not good but anything less than that is acceptable. sore achy etc you have to work through it

as far as supplemenst go, if you eat a balanced diet at your age you shouldnt need any. that being said its difficult these days to get everything you need from food because of how processed everything is. taking a cacium and magnesium supplement won’t hurt. nutritional intervention for joint health (glucosamine chondroiton etc) is stilla hot topic of discussion. there is no downside to taking that stuff as long as you’re not allergic to shelfish or have kidney issues, but may be a waste of money. taking supplements and not doing anythinf else IS a waste of money.

if you presented to our clinic with this injury this is how we would proceed once we know the fracture is stable. you would likely recieve soft tissue therpay that would consist of deep tissue massage and active release therapy to restore the injured soft tissue, as well as joint manipulation to restore the joint biomechanics of the spine. you would be given a regiment of stretching and mobilization “exercises” to do at home and counselled on the best way (for you) to regain your strength, wether its by general sporting or recreation activity, or some sort of resistance training. it is important to be active for your general health and recovery from this injury. you would be treated a couple of times per week for 3 weeks to 3 months, its impossible for me to say exactly without knowing all your history signs and symptoms etc

so my apologies this is quite generalized and vague, i did not have time to read the entire thread, life is abit hectic these days! my personal email is .(JavaScript must be enabled to view this email address) if you would like to contact me about any specific questions you have please feel free and i’ll do my best to get back to you ina timely manner

best wishes

Jason

 
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Jason, your reply is very much appreciated, possibly the best I have had from anyone in the medical community up till this point.  The only thing that I have been told relating to the disc was from the ortho surgeon, all she said was something about because the disc is no longer being held properly by the vertebrae due to the compression the disc will probably deteriorate significantly and something will need to be done about it.  What that is or if there was anything I could do to prevent this wasn’t brought up, it was a very closed discussion, almost like she was talking to herself.

I would love to go see a physio, getting the right one would be key, if I was still in Melbourne that would be easy as the guy I was seeing was the physio for the Carlton football club.To be quite honest I have never seen a chiro only ever a physio and have only ever regarded chiro with a fair degree of suspicion, warranted or unwarranted I don’t know.

With a back injury can I do any kind of light weights?  I am not sure if I can or should do any stomach exercises as all of them use the spine and most of them involve using the spine through the range of motion in which it was injured.  The only things I can think of that don’t would be isometric exercises that will still put some strain on the spine like a granage (spelling?).  I am trying to remember to tense my stomach muscles when I am sitting, standing walking etc, is there anything that might be useful?  The same would go for stretching, what should I go about doing or does the as long as it’s just a dull ache and not a sharp pain hold true for all of the above?

 
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ozgirl - 21 June 2012 06:18 AM

What thats crazy Mizu!!!

And to think how much that little snip will save them possibly in the long run!

Yeah, my thoughts exactly!!!!! You would think that they would not only happily pay the full amount, but they would be sendin me a christmas present for the next 5 years as well?????

 
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nthnbeachesguy - 21 June 2012 02:08 AM

Ok well I’m not super happy today.  I went to see an ortho surgeon based on my GP telling me they may be able to offer some ideas on treatment in the way of speeding up my recovery.  What a waste of time and money, $250 for ten minutes , all I got out of it is that it’s impressive how little pain I have and they can’t do anything at all for me.  If I’m still in pain in November I will need a full standing spine Xray to see what’s wrong otherwise it’s just rest for 8 weeks or until I’m painfree.  I can do what I want as it’s not likely to cause any further damage but it might cause some pain.  I really don’t know WTF I’m sposed to do.  She also mentioned that my disc may deteriorate for some reason that wasn’t made clear and if that happens I will need to have something done, what that was wasn’t even alluded to.

I’m happy to try anything, I would love to get another opinion from someone that specialises in sports injuries, everyone in the surgery I went to, and there would have been 20, was past retirement age.  I’m not willing to go pay $250 to go and hear them tell me the same thing however.  If anyone has anything to add please let me know, Spaz you intimated you had more to add in your first post, feel free to please. 

I think perhaps I may have had a little too much pinned on a positive outcome from specialist, at least an option of some kind would have been nice but was basically told na, nothing and chances are in a few years you’re going to be rooted, oh joy.

What a joke. $250 for nothing. I hate when you come across specialists like this, they look down on your and don’t bother explaining anything or wonder why you could possible ever question them or want another opinion. The only way around it is to have a prepared list of questions you want answers to and make sure they answer them. its pretty hard though because you expect them to do their job and cover all the angles for you. I recently was in hospital and had a specialist say ’ oh you are going to need surgery etc etc etc’ and i said ‘well, I’ve read a few papers in American journal of medicine saying that surgery for this is is not recommended any more’, the specialist then consulted someone else and came back and said they had changed their mind. If I had not said anything I would’ve went under the knife!

 
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Yeah, I agree 100% with what ya said there CRACKERS!!!!!

I always go into the consultation with the perception of being a very high chance of them might not knowing what they are on about!!!!! I always follow up with, or doin pre consultation homework myself!!!!!

When I was a kid I used to think that people like doctors know exactly what was goin on, but now as an adult have seen that it is definitely not always the case!!!!!

 
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I gotta ask, have you asked the doctors whether it’s cool to have that bit of bone floating around in there like that?  If it were me I’d want to know whether that was going to be just a cosmetic defect (and if so, how bad) or also cause functional problems or pain.  When I smashed my shoulder up the idiot doctors at the public hospital recommended to just leave it as it was just a cosmetic issue.  At this stage the bones were sticking way up under my skin.  There was no way I was going to accept that, even cosmetically, but more importantly I couldn’t believe it would function properly and with full strength like that.  Anyway, after a consultation with a private surgeon I got it fixed.  He told me after the op “it’s lucky we did the op because the damage was worse than it looked and you would have had pain for the rest of your life if we hadn’t done it”.

 
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^^ AC joint separation?

 
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rider26 - 22 June 2012 04:56 AM

^^ AC joint separation?

That’s more of a ligament than a bone, yeah?????

 
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Yes, AC.  There was also some damage to the ends of some of the bones.

 
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That bit of bone isn’t floating apparently and will end up looking like that just being solid bone once it sets.  I have asked and was told it’s pretty normal for them to set like that without issue.  I had some concerns about it as well to be honest but from what I can gather it should be ok.

 
nthnbeachesguy - 21 June 2012 10:21 PM

Jason, your reply is very much appreciated, possibly the best I have had from anyone in the medical community up till this point.  The only thing that I have been told relating to the disc was from the ortho surgeon, all she said was something about because the disc is no longer being held properly by the vertebrae due to the compression the disc will probably deteriorate significantly and something will need to be done about it.  What that is or if there was anything I could do to prevent this wasn’t brought up, it was a very closed discussion, almost like she was talking to herself.

I would love to go see a physio, getting the right one would be key, if I was still in Melbourne that would be easy as the guy I was seeing was the physio for the Carlton football club.To be quite honest I have never seen a chiro only ever a physio and have only ever regarded chiro with a fair degree of suspicion, warranted or unwarranted I don’t know.

With a back injury can I do any kind of light weights?  I am not sure if I can or should do any stomach exercises as all of them use the spine and most of them involve using the spine through the range of motion in which it was injured.  The only things I can think of that don’t would be isometric exercises that will still put some strain on the spine like a granage (spelling?).  I am trying to remember to tense my stomach muscles when I am sitting, standing walking etc, is there anything that might be useful?  The same would go for stretching, what should I go about doing or does the as long as it’s just a dull ache and not a sharp pain hold true for all of the above?

that disc will likely deteriorate faster than the other ones, they all do as you age but it doesn’t necessarily mean something will have to be done about it (ie surgery). even so clinical trials for disc replacements are almost done and its likely they will be somewhat common in the next 15 - 20 years (like knee or hip replacements). the best way to keep all your discs as healthy as possible is to eat healthy stay hydrated and be active.

in my opinion you should work back into weight trainimg and core strength exercises asap. it is ok for you to feel some discomfort in the spine while you perform exercises/stretching/core exercises unless the pain is very sharp, or increasing as you perform them. or if an hour or two after the exercises your pain is significantly higher than during or before the exercises and persists. we usually tell people to “listen to their body, it will let you know”. life is based around motion and many of your physiologic processes relay on tissue movement to be healthy. there will likely be some discomfort you will have to endure/work through but you don’t want to push it or cause harm, this is a fine line and its hard to tell what is too much so start slowly and and more over time. the idea you have to sit back and wait for it to heal before you start doing exercises is completely backward, the injured tissue has to be challneged a bit for it to heal properly, if that makes sense.

 
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nthnbeachesguy - 23 June 2012 12:54 PM

That bit of bone isn’t floating apparently and will end up looking like that just being solid bone once it sets.  I have asked and was told it’s pretty normal for them to set like that without issue.  I had some concerns about it as well to be honest but from what I can gather it should be ok.

cool mate, just don’t want you to end up looking like a stegosaurus.

 
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Fark! That is a full on broken back mate, not what I call a fracture (a crack). It’s a compression break like someone said (maybe Jason).

Sorry I haven’t revisited for a bit.
After reading your history and experience at 15yo regarding bone healing I’m afraid you are someone how requires the full amount of time to recover if not a little longer.
At 33 you have time to change your body and improve your fundamental physiology. So Hope is not lost.

I’m too surprised about the amount of pain your feeling, You obviously didn’t do too much damage to the soft tissue.
Regarding TigerBalm and other ointments. They don’t go much deeper than skin layer and don’t penetrate deep into the muscle, they offer excellent psychological assistance to physical manipulation of the muscle (massage) and the mind (psyche) does more healing than than the body anyway.

Was good reading Jason’s input and hearing what the specialist said regarding the bone change not affecting the soft tissue around it. That was my major concern.

Got to go be a dad again… will return sooner than my last effort.

 
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My thought is that diet should be your major concern right now.

Anything that is going to make your organs do more than they need should be reduced as much as possible. Alcohol, sugar, salts, smoking, processed foods, medications - You know the drill.
Basically your organs filter both what goes in and what comes out of your body. When damage occurs there is a lot of stuff that needs removing; if your filters are busy doing other work they wont get the crap out that they needs to.

This is why water is so important, water is the main carrier to move stuff around your body. Cells are cleansed through osmosis, dead or damaged cells need to be flushed so you can grow new cells or duplicate from old ones.

You need bone tissue. I haven’t tested the theory of digesting bone (I have a spectacularly strong skeletal structure - never had a compression break). At the very least you should get bone marrow into you.

Your back is never going to be the same! You are going to have to learn to adapt to new soft tissue structure around that area. This is not a bad thing - it could be quiet the reverse. The thing is getting it (and your bone) to heal in a “operating” manner - not a resting one.
Laying still while it heals is training the new cells to expect that. If it grows and repairs around activity you will grow a much stronger and adapted form.

Learning to listen to your body and the different types of pain is tricky.
PAIN is weakness leaving the body. Problem is it you can strengthen yourself to ignore damage occurring.

IF, IF, IF IF….
You had all the diagnostics to begin with, it is possible to use the muscle to hold the bone in position (acting like a cast) - there is no way in hell I would do that to the spine though. It is far to important to mess with that area. Your very lucky considering the extent of the break.

First up you need to ensure the bone is fusing strongly - you have taken considerable time in the past for this to occur. A good diet (multivitamins will help).
Then get good and strong.

You have mentioned crunching. It doesn’t have to be a crunch (or clench) just sucking in your belly has better results - imagine pulling your belly button to your spine. The best place to do this is while sitting in the car, driving. It puts your gut in a good position and improves digestive flow (another organ working well).