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Injury due to fall, hip pain, taken painkiller, bed rest, done CT scan, history of constipation

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Orthopaedic Surgeon
Practicing since : 2000
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My mother fell on the floor & got an injury 3weeks back.she has no significant pain in vertebral region.she took pain killer for two days after injury & since after that she is no longer taking any medicine for that purpose.she is on complete bed rest till date.However she complains mild pain in her right hip.On one or two occasion she walked for few steps but didn’t experience any pain in her back.
Please find Digital XRay & CT Scan reports as below:
1.Digital XRay of DL Spine AP/LAT : (Date 07.09.11)
Collapse compression with grade II anterior wedging of L1 vertebra....? post traumatic.
Disc spaces are normal.Pedicles are normal.No paravertebral opacity seen.Osteoporosis is seen.

Reveals burst fracture of D12 vertebral body with mild reduction of heights (~ 25%). superior & inferior end plates are focally depressed. There is minimal retropulsion of posterior cortex. The mid sagittal residual AP diameter is 12mm. pedicels,lamina, spinous and facetal processes are normal.
There is sacralisation of L5.
There is mild anterior spondylolisthesis of L4 over L5. No Pars interarticularis defect There is gross facetal arthropathic changes seen.
Rest of the vertebral bodies are normal in height. small anterior osteo phytes are present at multiple levels.
Ther is large mass in the right suprarenal region measuring 78×63×86 mms in size with predomint fat content. No Calcification seen.
Brust fracture D12 Vertebral body---unstable injury( two column involvement) with minimal retropulsion,
sacralisation of L5.
Anterior spondylolisthesis of L4 over L5 (degenerative).
Gross facetal arthropathy at L4-L5.
Right suprarenal mass- angiomyelolipoma.

Medical History
Age-62 yrs, Height- 5 ft, weight-78 kg,
Bowel habit- constipated,
Neurological condition- Intact, No bowel or bladder dysfunction.
Medication- consuming amlodipine – atenalol,( Last 5yrs) atorvastatin-10 ( intermittent), Alprazolam..25mg, ( Last 15 yrs) & Amtriptyline+ chlordiazepoxide ( 15 yrs).

Posted Tue, 8 May 2012 in Back Pain
Answered by Dr. Atul Wankhede 11 hours later

Thanks for posting the question.

I presume your mother is having considerable inconvenience because of the fall. It is evident from CT scan that she has a fracture of 12th thoracic vertebra, though I have doubt on the authencity of the Xray report since they mentioned fractured 1st lumbar vertebra and have no mention of L 5 sacralisation. Nevertheless an MRI of spine is of more significance since it describes the condition of the spinal cord. Cord compromise is of utmost importance in your mothers case. Besides, CT shows facetal arthropathy which again predisposes to nerve root impingement.

In my opinion, adequate bed rest has been taken. She may take pain killers as and when necessary. She needs to wear a 'Taylor's ' brace at earliest. That will help her keep good posture. Take her to a physiotherapist to teach her 'log rolling'. That will be necessary for avoiding further complications. Ask her to avoid forward bending and back twisting at all costs.

This should work fine for now. If she starts having weakness of her legs with tingling or numbness, get an MRI done without further delay.

I hope I've answered your query. If you need more assistance I'm available for follow up.

Above answer was peer-reviewed by
Follow-up: Injury due to fall, hip pain, taken painkiller, bed rest, done CT scan, history of constipation 10 hours later
1.How long she needs to wear Taylor's brace?
2.Whether she can sit on chair & use commode for toilet?
Answered by Dr. Atul Wankhede 1 hour later
Hello once again.
She needs to use the brace for a period of 6-8 weeks. She may continue using it further till she feels symptomatically stable, i.e painless and no neurological involvement.
She may use commode and carry on sitting on chair as long as she can tolerate.

For early recovery ask your physician for a calcium supplement and bisphosphonate's dose. Hope she recovers soon.
I shall be glad to assist you further if you need more help.

Good luck.
Above answer was peer-reviewed by
Follow-up: Injury due to fall, hip pain, taken painkiller, bed rest, done CT scan, history of constipation 20 hours later
1.Whether she needs to wear Taylor's brace when she sleeps?
Answered by Dr. Atul Wankhede 1 hour later

Thanks for writing back.

She has to remove the brace while sleeping, using restroom and while doing exercises. Mind you she has to do extention exercises and not flexion or forward bending ones. Exercises can be commensed after a span of month and to be carried on life long.

Wish her an early recovery and a healthy life.
Above answer was peer-reviewed by
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