Spine Fractures Increased During the Pandemic

There are many diseases that occur with age and affect the quality of life. Although the first ones that come to mind are cardiovascular diseases, tumoral diseases, respiratory diseases, obesity, mental health diseases, it is definitely osteoporosis, which reduces the carrying quality and capacity of the skeletal system. we must not forget.

Underlining that the immobility experienced as a result of the restrictions applied to those over 65 years of age, especially during the pandemic period, causes osteoporotic fractures and the increase in the number of surgeries due to this, Bayındır Health Group, one of the group companies of Türkiye İş Bankası, Head of the Department of Brain and Nerve Surgery at Bayındır İçerenköy Hospital, Prof. Dr. Murat Servan Döşoğlu gave information about spinal fractures caused by osteoporosis and their treatments.

The COVID-1.5 pandemic, which we have been fighting for the last 19 years, has changed our lifestyle, limiting our daily routine activities and sports habits. In particular, individuals over the age of 65 began to live a sedentary life as a reflection of the long periods spent at home. This state of inactivation affects bone health in older people, causing an increase in osteoporosis and related fractures.

Stating that restrictions and a lifestyle spent at home with the fear of catching a disease outside, cortisone drugs used in the treatment of COVID-19 also trigger the development of osteoporosis, Bayındır İçerenköy Hospital Head of Neurosurgery Department Prof. Dr. Murat Servan Döşoğlu said, “The number of osteoporotic fractures and related surgeries has increased considerably during the pandemic period. The fear of going to the hospital due to COVID-19 and the decision to wait at home by accepting the pain causes delay in the diagnosis and the progression of the fracture and the hump of the spine. However, with early diagnosis, patients can both get rid of pain and prevent slouching, posture and gait disorders that may occur in the late period.

EVEN DAILY MOVEMENTS CAN CAUSE A SPINE FRACTURE

Osteoporosis impairs the bearing quality and capacity of the skeletal system by reducing the mass of the inner part of the bone. This decrease in bone content leads to bone fragility and thus fractures.

Stating that in the early stages of osteoporosis, tolerable and widespread pain occurs, Prof. Dr. Murat Servan Döşoğlu continued his words as follows: “While osteoporotic fractures are usually seen after a trauma at the beginning, they can also be seen in the future without a serious trauma. This type of fracture, which is defined as low-energy fractures, can occur while sitting, lying or even turning. Fractures are most common in the spine or long bones.”

A MOBILE LIFE IS AS VITAL AS NUTRITION

Stating that the balance of calcium and phosphorus in the body and the hormones called parathormone and calcitonin, which control this balance, are very important for our bone health. Dr. Murat Servan Döşoğlu said, “In addition, vitamin D level, sun exposure and, more importantly, an active lifestyle are the most important factors that stimulate bone formation, protect bone health and prevent osteoporosis. In order to protect and maintain skeletal health, mechanical stimulation of bones, including running, walking, working and even sitting, and an active life are as important as nutrition. Lying down and becoming bedridden will cause rapid bone destruction with inactivity, formation of pores in the bone content and resorption. Smoking, drinking, unbalanced diet, overweight and respiratory diseases have negative effects on bone health. In addition, the presence of osteoporosis in the family is one of the important risk factors for fracture formation.

SPINE FRACTURES CAUSE POSTURE AND GAIT PROBLEMS

Stating that there are several types of osteoporotic fractures of the spine, but usually in the form of wedges, Brain and Nerve Surgery Specialist Prof. Dr. Murat Servan Döşoğlu said, “While those with wedging fractures apply to the hospital with only severe back or low back pain; In those with other types of compression fractures, besides pain, spinal cord and nerve compression are present, and various strength and sensory defects of the crushed nerve, urinary and stool control problems, etc. complaints occur. Depending on the type of spinal fractures, their treatment also varies. Wedge fractures were formerly treated medically by lying in bed or on a plaster bed for 6-8 weeks. In this method, the patient spends this period of time with pain, which may cause an increase in fractures and new findings that were not present at the beginning, despite lying down. Today, wedging fractures are treated with cement (cement) injected into the vertebrae, and the patient can both get rid of the pain immediately and get up immediately.

TREATMENT NEEDS TO BE PLANNED ACCORDING TO THE KIND OF FRACTURE

“Treatment of compression fractures is both urgent and difficult. As the damage to the carrier system becomes more severe, it can cause the spinal cord to be crushed and cause mobility in the spine. The walking and sitting of these patients may lead to spinal slippage and the emergence or increase of neurological findings. For this reason, patients with fractures that cause mobility are prevented from standing up and these fractures are only treated with a more difficult and heavy surgery such as screwing-inserting a device. Wedge fractures, on the other hand, are more advantageous for the patient as they are of a milder type and only cause pain. These fractures are easier to treat as they are not movable. However, if they are not treated, they can change into a difficult type and progress,” said Prof. Dr. Murat Servan Döşoğlu explained that wedging fractures are treated in the operating room, under local or general anesthesia and under scopy (x-ray) control: “With the methods called kyphoplasty or vertebroplasty, the wedged bone is entered with the help of a needle and the collapsed bone roof is raised and strengthened by inserting cement into the bone. In this procedure, severe back or low back pain in the patient is immediately resolved with the elimination of the collapse and the normalization of the bone morphology, and the risk of hunching that may occur in the late period is eliminated. After the procedure, the patient can easily stand up and walk. Since the spine itself is strengthened, the need for external support such as a corset is eliminated and the limitations applied to the patient are removed.