Name of the Procedure:

Closed Treatment of Vertebral Fracture(s) and/or Dislocation(s) with Casting or Bracing by Manipulation or Traction

Summary

The closed treatment of vertebral fractures or dislocations involves realigning the spine without surgical intervention. This procedure uses external methods such as casting, bracing, manipulation, or traction to stabilize the spine and promote healing.

Purpose

This procedure addresses spinal fractures or dislocations often caused by trauma, such as falls or car accidents. The goals are to realign the spinal bones, stabilize the spine, reduce pain, and prevent further injury or deformity.

Indications

• Acute back pain following trauma
• Visible deformity or misalignment of the spine
• Neurological symptoms such as numbness, weakness, or paralysis
• Diagnostic imaging showing vertebral fractures or dislocations

Preparation

• Fasting may be required if sedation is used.
• Patients may need to adjust their medications, especially blood thinners.
• Pre-procedure imaging tests, such as X-rays, CT scans, or MRIs, to assess the extent of the injury.

Procedure Description

1. Assessment: The patient undergoes clinical evaluation and imaging to confirm the diagnosis.
2. Sedation/Anesthesia: Depending on the severity and location of the fracture or dislocation, local anesthesia or sedation may be administered.
3. Manipulation/Traction: The healthcare provider manually manipulates the spine to realign the vertebrae. Traction devices may be used to gently apply force and reposition the spinal bones.

4. Casting/Bracing: Once aligned, a cast or brace is applied to maintain proper spine position during healing. This external support restricts movement and helps the bones heal in the correct alignment.

   Tools and Equipment: Spinal braces, casts, traction devices, imaging tools (X-rays, CT, MRI), and immobilization pads.

Duration

The procedure typically takes 1 to 2 hours, depending on complexity and the patient's condition.

Setting

This procedure can be performed in a hospital, outpatient surgical center, or specialized orthopedic clinic.

Personnel

• Orthopedic surgeon or spine specialist
• Nurses and medical assistants
• Radiologist for imaging
• Anesthesiologist if sedation or anesthesia is needed

Risks and Complications

• Pain or discomfort during manipulation
• Incomplete or improper alignment
• Skin irritation or pressure sores from casting or bracing
• Rarely, neurological complications or issues with blood flow

Benefits

• Non-surgical alignment and stabilization of the spine
• Reduced pain and prevention of further spinal injury
• Gradual return to normal activities with proper spine healing
• Shorter recovery time compared to surgical alternatives

Recovery

• Patients might wear the cast or brace for several weeks to months.
• Follow-up appointments to monitor healing with regular imaging.
• Physical therapy may be recommended to strengthen spine-supporting muscles.
• Restrictions on certain activities, such as lifting heavy objects or high-impact sports, during recovery.

Alternatives

• Surgical intervention if the fracture or dislocation is severe or doesn't respond to closed treatment.
• Pain management and physiotherapy alone, though this may not address alignment.
• Cons of alternatives: Surgical options carry higher risks and a longer recovery period.

Patient Experience

• Initial discomfort during manipulation or traction.
• Mild pain or pressure from the cast or brace, which usually subsides as the patient adjusts.
• Medications may be prescribed to manage pain.
• Gradual improvement in mobility and pain levels over several weeks.