Q. What is the specific treatment for compressive spine fracture?

Answered by
Dr. J Mariano Anto Bruno Mascarenhas
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 04, 2016 and last reviewed on: Apr 06, 2020

Hello doctor,

I have a case of a 47 year old man, who went through a car accident. The scan showed a compressive fracture of T12 wth predominance into the canal 7 mm. The patient was told to stay in bed with a plastic corsage around his waist to prevent sudden movements. Around two to three months later the patient was able to sit and stand, but he did not remove the plastic corsage. Then five months later, which is two weeks ago, the patient could not move his right leg and he could barely feel his right arm. He did a scan and the result as follows. Multiple subcortical and periventricular hypo dense lesions on both hemispheres. Calcified arteriosclerotic plates on arteria vertebralis dexter. No distinguishable lesions on posterior cranial fossa. Free basal cisterns. Free paranasal sinuses. Overall, it says that the multiple ischemic lesions lead towards vasculitis. I must include that the patient suffers from heart pressure and diabetes. Can you lead me to a specific path of treatment? How dangerous is this diagnosis?

Dr. J Mariano Anto Bruno Mascarenhas

Neuro Surgery Neurology Spine Health Spine Surgery

Hi, Welcome to icliniq.com.I have read your question with care and understood the concern.

  • The inability to move the right leg could be due to compressive fracture T12 or periventricular hypodense lesions.
  • Barely feeling right arm is due to periventricular hypodense lesions or some undiagnosed problem in the cervical spine.
  • Multiple subcortical and periventricular hypodense lesions on both hemispheres are due to multiple small infarcts. This is due to long standing diabetes and hypertension.
  • So, the specific path of treatment would be to do a nerve conduction study to determine whether the inability to move right leg is due to compression in cervical level or distal. If that is due to compression, then surgical decompression is needed.
  • Management of multi infarct dementia by control of blood sugar, control of blood pressure and drugs that improve the nerve functions like Piracetam and Citicoline.

For further information consult a neurologist online --> https://www.icliniq.com/ask-a-doctor-online/neurologist

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