Thoracolumbar Fracture

WHAT YOU SHOULD KNOW:

Thoracolumbar Fracture (Inpatient Care) Care Guide

  • A thoracolumbar fracture is a break in one or more of your thoracic and lumbar vertebrae. The vertebrae are the bones that make up your spine. The thoracic vertebrae are the 12 bones between your neck and your lower back. They are connected to your ribs and help the ribs move when breathing. The lumbar vertebrae are the five bones between your chest and hips. Lumbar bones are the largest and strongest of all vertebrae.

  • Thoracolumbar fractures are usually caused by injury to the spine from a car accident or falling from a great height. Symptoms may include pain or bruising or swelling on the back. The spinal cord may also be damaged with severe injuries. Symptoms may also include decreased feeling, weakness, or paralysis (loss of movement) of the legs. To diagnosis a fracture, you may need a spine x-ray, magnetic resonance imaging (MRI), or a computerized tomography (CT) scan. The location and type of fracture will determine your treatment.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

  • Any injury to your vertebrae (bones that make up your spine) may cause problems. Your spinal cord lies in the center of your vertebrae. The spinal cord is where the nerves from your brain go to the rest of the body. Injury to the spinal cord may lead to paralysis of the body from the level of injury downward.

  • You may get a blood clot in your leg or arm. This can cause pain and swelling, and it can stop blood from flowing where it needs to go in your body. The blood clot can break loose and travel to your lungs. A blood clot in your lungs can cause chest pain and trouble breathing. This problem can be life-threatening.

  • Early diagnosis of the type and severity of the thoracolumbar injury is very important. Call your caregiver if you have concerns about your fracture, medicines, or care.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Medicines:

You may be given the following medicines:

  • Medicines to treat pain, swelling, or fever: These medicines are safe for most people to use. However, they can cause serious problems when used by people with certain medical conditions. Tell caregivers if you have liver or kidney disease or a history of bleeding in your stomach.

Physical therapy:

You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Tests:

  • Computerized tomography scan: This is also called a CT or CAT scan. A special x-ray machine uses a computer to take pictures of your spine. You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

  • Magnetic resonance imaging: This test is also called an MRI. During the MRI, pictures are taken of your spine. You will need to lie still during a MRI. Never enter the MRI room with an oxygen tank, watch, or any other metal objects. This can cause serious injury. Tell your caregiver if you have any metal implants in your body.

  • X-rays: You may need x-rays of the thoracolumbar area to check for broken bones or other problems.

  • Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.

Treatment options:

Treatment will depend on which bones were damaged and the kind of fracture you have. Thoracolumbar fractures that are mild may be treated with bed rest. For support, you may need to wear a back brace or have a cast made for your back. Sometimes a corset (binder) may be used to support a weak spine. To decrease the load on a broken spine, you may need to use a walker. A severe thoracolumbar fracture may require surgery to return the bones to their normal position.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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