Spinous process fracture

　　1. The location of the spinous process fracture is mostly above the base of the spinous process. When the interspinous ligament and supraspinous ligament are torn along with the fracture, the avulsion fracture is in a sequence with the spinous process of the lower vertebra, separated from the lower spinous process. This injury does not involve the vertebral canal and intervertebral foramen, nor does it accompany nerve injury.

　　2. Caused by excessive flexion of the cervical spine. When the head and neck are struck by a heavy object, causing the cervical spine to abruptly flex, the spinous process and muscles below the point of force application are subjected to strong opposing traction, resulting in avulsion fracture of the spinous process. When a shovel worker swings a shovel, sudden and excessive force causes the scapular muscle to contract intensely and becomes uncoordinated with the trapezius muscle, leading to a spinous process fracture. It can be a single or double cervical vertebral fracture.

　　Local hematoma, swelling, marked tenderness with crepitus. One should pay attention to concurrent cervical vertebral body fracture-dislocation or lamina fracture. Severe cervical vertebral body fractures have three types:

　　1. Semi-dislocation of the cervical vertebra:It is relatively common. It can be caused by sudden braking of a car, where the passenger's head is thrown forward due to inertia. This injury is easily overlooked and can lead to paraplegia.

　　2. Fracture of the cervical vertebral body:It often occurs in the cervical vertebrae 5 to 7, caused by excessive flexion. It often combines dislocation and acute prolapse of intervertebral disc, leading to spinal cord injury.

　　3. Cervical dislocation:Mostly caused by flexion injuries. After the anterior margin of the next vertebral body is compressed, the displaced vertebral body moves forward, and one or both intervertebral small joints may lock, and the spinal cord is often bruised or compressed. Therefore, in the presence of the above history of trauma, one should be vigilant about the possibility of vertebral body fractures in the cervical spine.

　　Local tenderness, local pain, swelling, and limited cervical motion. The spinous process can be felt to move, and subcutaneous ecchymosis can be seen. The site of spinous process fractures is often above the base of the spinous process. When the interspinous ligament and nuchal ligament are torn, the avulsion fracture is in a sequential arrangement with the spinous process of the lower vertebra, and it is separated from the lower spinous process.

　　Cervical spondylotic myelopathy should be treated with surgery in the early stage to avoid irreversible spinal cord injury caused by purposeless delay. With the improvement of surgical techniques, the ability to avoid surgical risks is constantly increasing, and more and more patients with cervical spondylotic myelopathy are receiving surgical treatment. The direct resection of the compressive material from the anterior aspect of the spinal canal is the most effective treatment to date for chronic cervical spinal cord compression. The direct resection of the compressive material, such as degenerated intervertebral discs, osteophytes, posterior longitudinal ligament, and its adhesions, is the direct target of surgical intervention and must be completely removed. Direct resection of the compressive material may improve and improve or compensate for the reduced blood supply to the spinal cord.

　　At the time of diagnosis, in addition to relying on clinical manifestations, auxiliary examinations are also needed. This disease has three common types of spinous process fractures: longitudinal fracture from the root or central thin part; transverse splitting into upper and lower halves; and comminuted fracture.

　　一、Should

　　1. Eat more fresh vegetables and fruits.

　　2. Eat more vegetables rich in vitamin C, such as green peppers, tomatoes, amaranth, green vegetables, cabbage, and radishes, to promote the growth of bone calluses and wound healing.

　　3. Supplement trace elements such as zinc, iron, and manganese. Animal liver, seafood, soybeans, sunflower seeds, and mushrooms contain a lot of zinc; animal liver, eggs, legumes, green vegetables, and wheat flour contain a lot of iron; oatmeal, turnips, egg yolks, and cheese contain a lot of manganese.

　　二、Avoid

　　1. Avoid blindly supplementing calcium. Blindly supplementing calcium during the bedridden period after a fracture is of no benefit and may even be harmful.

　　2. Avoid eating too much meat and bones. Some people believe that eating more meat and bones after a fracture can promote early healing. However, this is not the case. Modern medicine has proven through multiple practices that eating more meat and bones after a fracture not only does not promote early healing but may also delay the healing time of the fracture.

　　3. Avoid eating foods that are easy to cause bloating or indigestion, such as sweet potatoes, taro, and glutinous rice.

　　4. Avoid drinking less water and staying in bed for patients with fractures, especially those with spinal, pelvic, and lower limb fractures, as their mobility is very limited. Therefore, they should try to drink less water to reduce the frequency of urination. Although this may reduce the frequency of urination, it also brings about greater trouble. If bedridden patients have less activity, weakened intestinal peristalsis, and reduced water intake, it is easy to cause constipation. Long-term bed rest can also lead to urinary retention and increase the risk of urinary tract stones and urinary system infections. Therefore, bedridden fracture patients should drink water as needed without excessive concern.

　　5. Avoid excessive consumption of sugar. After excessive intake of sugar, a rapid metabolism of glucose will occur, thus producing intermediate substances of metabolism, such as pyruvate, lactic acid, etc., causing the body to be in an acidic poisoning state. At this time, alkaline calcium, magnesium, sodium ions, etc., will immediately be mobilized to participate in neutralization to prevent the blood from becoming acidic. Such a large consumption of calcium is not conducive to the recovery of fracture patients. At the same time, excessive sugar will also reduce the content of vitamin B1 in the body. Vitamin B1 is a substance that is essential for the conversion of sugar into energy in the body. Insufficient vitamin B1 will greatly reduce the activity of nerves and muscles and also affect the recovery of function. Therefore, fracture patients should avoid eating excessive sugar.

　　6. Avoid long-term use of Sanqi tablets. In the early stage of fracture, local internal bleeding occurs, with blood stasis, swelling, and pain. At this time, taking Sanqi tablets can contract the local blood vessels, shorten the coagulation time, increase the thrombin, which is very appropriate. However, after one week of fracture reduction, bleeding has stopped and the damaged tissue has begun to repair. Repair requires a large amount of blood supply. If Sanqi tablets are continued to be taken, the local blood vessels are in a state of constriction, blood circulation is not smooth, which is not conducive to fracture healing.

　　7. Prohibit drinking fruit juice. Fractures are prohibited.

　　1. For those with displacement, occipital and mandibular traction should be applied, and the cervical spine should be slightly extended to relax the neck muscles and allow the fracture to recover its position. Therefore, the traction force should be between 2~3kg. After reduction, the neck brace can be used to stabilize; for those without displacement, cervical and mandibular fixation can be directly applied, which can last for 2~3 months until the fracture heals.

　　The manifestation of cervical spondylosis myelopathy is often the onset of lower limb motor dysfunction before the upper limb, mainly manifested as slight weakness in the lower limbs when walking, numbness in the lower limbs and fingers, fine motor skills disorder (such as awkwardness in holding a pen to write, holding chopsticks, etc.), neck and shoulder soreness and discomfort. With the extension of the course of the disease and the aggravation of the condition, instability when walking, a feeling of stepping on cotton, difficulty in holding objects, severe numbness in the limbs, serious decrease in the coordination ability of the limbs, and a sense of constraint in the chest and abdomen. This is mainly due to the pressure on the cervical cord caused by the bone spurs of the posterior margin of the vertebral bodies and the protruding intervertebral disc tissue, leading to the involvement and变性 of the pyramidal tract.