First Lumbar Vertebra Compression Fracture

The first lumbar vertebra compression fracture poses a substantial health risk and significantly impairs patients' mobility. Prompt intervention is imperative upon diagnosis. However, to devise an effective, patient-specific treatment plan, a thorough understanding of the patient's condition is paramount. This article outlines the essential steps in managing a first lumbar vertebra compression fracture.

1. Diagnosis

Upon sustaining a lumbar vertebra compression fracture, the initial step is to seek medical attention for diagnosis. The subsequent treatment plan will be tailored to the fracture's severity. If surgery is indicated, postoperative radiographs will be taken three days later. With favorable conditions, patients may embark on lumbar muscle strengthening exercises while ambulant, with complete recovery anticipated in approximately three months. Alternatively, for conservative rest-based treatment, resumption of activities typically occurs around the two-month mark, contingent upon follow-up radiographs.

2. Surgical Treatment

When lumbar vertebral body compression exceeds 40% and the posterior concave angle surpasses 25° to 30°, it signifies an unstable fracture, potentially indicating posterior column ligament damage. In such cases, surgical intervention is generally advised. Postoperatively, negative pressure drainage is maintained for two days, followed by lumbar vertebrae radiographs on the third day. If the results are favorable, patients can commence functional exercises with waist support assistance.

3. Conservative Treatment

For lumbar vertebral body compression under 40% and an angle less than 25° to 30°, the fracture is deemed slightly stable. Surgical intervention is generally not recommended, and conservative approaches like bed rest and immobilization are preferred. During conservative treatment, regular radiographs are essential for monitoring within three months post-fracture. Based on the review radiographs, if recovery progresses well, patients can resume activities approximately two months later.