How to manage L1 compression fracture?
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Q. My test reports show an L1 compression fracture. Please advice.

Answered by
Dr. Muhammad Zubayer Alam
and medically reviewed by Dr. Preetha J
This is a premium question & answer published on Nov 09, 2020

Hi doctor,

I have done a CABP1 test and CT abdomen pelvis with contrast for periumbilical pain. Multiple axial CT images of the abdomen and pelvis with IV was done. The contrast was obtained, followed by 2D coronal reformats. And the contrast dose is 3.33 fl oz Omnipaque 350. All CT scans at this facility use dose modulation, iterative reconstruction, and or weight-based dosing when appropriate to reduce radiation dose to as low as reasonably achievable.

The findings were initial images of the lung bases are clear. Visualized heart size is normal. The liver is normal. No cholelithiasis. No biliary dilatation. The pancreas is normal. No pancreatic ductal dilatation is seen. No splenomegaly. Adrenal glands are normal. Kidneys enhance symmetrically. No hydronephrosis. The stomach is distended with oral contrast material. No dilated small. The bowel is seen. The appendix is not identified. By history, appendectomy. The portions of the ascending colon, hepatic flexure, and proximal. Transverse colon and rectum are under distended and partially decompressed. This degrades the evaluation of this segment of the colon. No adenopathy. The bladder is near completely collapsed with wall thickening. This degrades the evaluation of the bladder. Scattered atherosclerotic calcific lesions are present, age indeterminate L1 compression fracture. Please provide the prescription and advise on the CT scan report and blood test report.

#

Hi,

Welcome to icliniq.com.

Thanks for the query. I can understand your concern. According to your statement, you have recently done a CT (computed tomography) abdomen with pelvis with Contrast, which has revealed an L1 (lumbar spine) compression fracture, and your blood test revealed nothing significant. You have provided your investigation reports (attachment removed to protect patient identity) here but have not provided your clinical symptoms. You have not mentioned what you want to know or what type of help you want. I want to add that most lumbar compression fractures heal in two to three months with rest, using a back brace with some medications like painkillers, calcium plus vitamin D supplements, etc., and light exercise like walking. But your investigation report was done seven months back. So your L1 compression fracture related clinical sufferings have to be subsided. For that, I have asked you about your present clinical sufferings or queries. Please mention that. In case of any query, ask me.

Hi doctor,

I have been physically not significantly active during this corona period. I have recently started strengthening my leg muscles (for two weeks), and while doing so, I observed a lot of gas formation in my stomach and usually come out during the workout. Also, I was having pain in my stomach in my naval region until I finish my workout. Hence my primary care doctor asked me to have a CT scan of the abdomen with the pelvis region and advised me to consult a GI (gastrointestinal) doctor. She also did a full blood profile check-up suspecting diabetic and low hemoglobin levels. I did have a little back pain, but I did not complain about that as it was significantly less, and I was under the impression that it is just normal as it is significantly less, and maybe that is for my long working hours these days. But after seeing my CT scan result, I am scared.

I know I will have to consult an ortho doctor for that back pain, but it will take some time as they are not so available, and there is a long queue at this point. I have already taken an appointment on this month with a GI specialist.

#

Hi,

Welcome back to icliniq.com.

Thanks for the query again. Do not worry. You have provided excellent details of history regarding your present clinical symptoms with your CT abdomen with pelvis investigation outcomes.

Acid reflux, constipation, etc. may cause abdominal pain and gas. Again your investigation report has revealed that you have an L1 compression fracture. You should wear a back brace that will support and protect the affected area of your back. Take proper rest and do some light exercise, like walking. Avoid any strenuous exercise or activities. It will take time to heal, around 10 to 12 weeks. Only so rare cases may need surgical intervention. So, do repeat a CT Scan of the back after three months.

You can take the medications as follows,

  • Tablet Naprosyn (Naproxen) 500 mg after a meal in case of back pain.
  • Tablet Lioresal (Baclofen) 5 mg twice for ten days.
  • Tablet Citracal +D (Vitamin D and Calcium) once for two months.
  • Tablet Prevacid (Lansoprazole) 30 mg once before meal for one month.
  • Syrup Gaviscon (Aluminium hydroxide and Magnesium Carbonate) two tablespoon three times daily (after meal) for 15 days.

By following the medications mentioned above, you can subside your abdominal pain and back pain due to L1 compression fracture.

If any other query, knock me, and I will try to reply to you further.


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