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Hello, and welcome to this week’s episode of Empowering Women in Chiropractic. I’m your host, Dr. Cathy, and this week I want to talk with you about cervical compression fractures and how to not only identify them, But to educate your patients about what they are, how they were caused, what needs to happen to work with them in order to prevent long-term complications.
So let’s dive right in. I’ve got a couple little props here for you today. So we’re gonna start off with our spine model, and of course I got not the perfect. Beautiful healthy disc spine model, but I wanted to start off with one that’s already showing an issue and oftentimes our patients are used to seeing something very similar to this, which shows the disc has already been squashed, for lack of a better word.
The disc may be bulging, it’s putting pressure onto the nerves, and we’re starting to lose normal range of motion and normal function. But, That either have recently been in a car accident or have been in accidents in the past, and when they come into you, they’re typically presenting with a whole host of symptoms.
If it’s a recent car accident, they may be presenting with. Signs of concussion, traumatic brain injury, neck pain, radiating pain down the shoulders, even out to the arms and the hands. And when you take the x-rays, we’re gonna put up our first x-ray here so that you can see what you should be looking for so that you can truly educate your patients on what’s going on.
Oftentimes, I’ll have doctors that I coach that’ll look at an X-ray like this and say, but there’s a beautiful cervical curve, so what do we have going on? But if we start to look at c1, c2, they’re slightly off of our normal cervical curve line. And this of course is a C BP normal cervical curvature line.
But when we get down to C3 and c4, I want you to look at the inferior aspect. Of the anterior portion of c3 as it has come down to basically indent itself into the anterior superior portion of c4. That is a compression fracture. Now let’s follow down to c5. And again, on the anterior superior corner of c5, you don’t see a nice square bone.
What is an indentation of the bone. So the corner of C5 looks as if somebody just nicked it off or compressed it inside of itself. Keep moving down. And at the inferior aspect of C5 and the superior aspect of c6, you now see a wedge that’s taken out of that. Area. So it almost looks like a little kid was drawing a tree and they just wanted to cut the tree down.
They just chopped the V into the tree and they took a whole chunk out of those bones. So when we show these x-rays to our patients, it’s important for them to understand this is a compression fracture and this is the result. Of a forceful motion usually caused by the head slamming forward. So we’re gonna shrink this down and we’re gonna just talk a little bit about the mechanism of injury with this so that you can understand as somebody is riding along in a car, if they get hit from behind and their head slams forward, that forward motion is going to cause a lot of impact forward.
And that slamming forward will actually take one square bone and another square bone on top of itself. As you go forward, this slams down and it indents that bone. Now you have a square bone sitting on top of a bone with a wedge shape. What’s gonna happen over time? The superior bone is gonna fall forward.
Now, I like to keep a water bottle handle handy because this is a great way to explain a compression fracture to people, because most people, when they think of a fracture, they think of a bone that’s broken in half or broken in several pieces, whereas a compression fracture is very similar to taking a water bottle and just slamming it on your desk and showing your patient how the corner is now indented.
But unlike a water bottle that I could take the cover off, blow some air in and pop it back out, we can’t do that to your spine. Your spine is not like a water bottle. I can’t just make that indented bone pop back out. Now it’s important to understand that because over time this is going to change body mechanics, and this is going to change how we bear weight.
So if we pull up our next x-ray, we’re gonna show you what happens when this. Cervical compression fracture is left untreated and time passes. Now, obviously this is a different patient. You’ll see different structures here, but this is typically what you’re going to see after a compression fracture has been there for more than five to 10 years.
What happens? If we start to look at the different bones, we notice that they’re no longer square bones. We look at C3 and it’s starting to get that little hook down at the bottom or that little bit of liping and spurring. It’s at the early stages, but you can see that compression fracture on C4 as C3 is starting to come down.
Into that space. Now, if we look down, we keep moving down. C4, the inferior aspect of the anterior portion of C4 is starting to actually wedge out. It’s starting to make a broader base, and you could see that it’s white, it is whiter, where it is laying down more bone for support reasons, and that’s what’s going to happen over time.
Those compression fractures will alter the body mechanics. Now your spine is designed to carry 60% of the weight on the posterior aspects of your vertebral bodies, and only 40% on the actual body. So 60% should be on the posterior aspects of the vertebrae. 40% should be upfront. As long as we have a nice curve, we are bearing most of the weight on the posterior aspect, but the minute we shift.
Forward and we start bearing more weight on the front. This becomes a mechanical issue where your body can no longer support the weight of the head. So we’re gonna pick up another one of the tools that I use in the office, and hopefully you have one of these. I keep a bowling ball in the office because I do actually use this to demonstrate with good posture.
I can hold the bowling ball up here all day long. This is about a 10 pound bowling ball. Most people, their head will weigh about eight to 10 pounds, and as long as my head and my bowling ball is right here, I can do this all day long. Not a problem. I can walk around and carry my head here all day long, but.
The minute my head goes forward, the weight of my head is like holding this bowling ball out front. And when I demonstrate this with patients, I’m like, hurry up. Explain this to me, because if my head’s forward, my bowling ball is out front, guess what I have to do over time. I have to prop it up.
It’s going to get too heavy, and I need support from the other hand or the bone below to prop it up. And that is your degeneration. That is your lipping and spurring. Now, when you have lipping and spurring coming from this superior bone pointing down, it’s kinda like I’m falling forward. And I have to put out stabilizers.
So those are some of the ways that I’m able to visually explain this to patients for them to understand not only that there is an injury. That is causing whatever symptoms they may be experiencing, but that the symptoms may go away. But this problem needs to be corrected or over time it will continue to degenerate.
And as we know, if we start to do develop living and spurring those anterior spurs, if we start to develop that degeneration, it’s not just going to stop on its own. Those two bones will continue to grow and grow until they. Eventually touch and fuse and we lose that joint spacing, we’ll start to lose that disc.
We’ll lose the joint spacing, we’ll lose the mobility of that joint, which means as soon as you lose one joint, guess what happens to the neighboring joints? You start to lose them. So the joint above and the joint below will rapidly deteriorate because they are now overworking. So with all of that being said, this is your opportunity to educate your patients.
Oftentimes patient will come in and they don’t mention that they had an accident or that they got tackled in football or that they fell off a balance beam or that they were riding along in a Jeep that was going four wheeling. Cuz I’ve had this happen. They were going four wheeling and they hit so many bumps.
They actually hit their head on the roof of the Jeep or the roll bars above them and they don’t consider that to be a car accident, so they don’t mention it. Or they didn’t have a car accident last week, last month, or in the last, two months that brought them in. So they think that it’s not important for them to mention.
However, when you look at those x-rays and evidence of either a recent. Or an old compression fracture. It’s important to have this conversation because as we have those compression fractures and we start to lean forward and bear weight on the front of the spine, we will have to lay down more bone in the form of osteophytes, degeneration, liping and spurring, which will over time cause massive degeneration to that spot.
So what do we need to do? We need to get the weight bearing on the back of the vertebral. Segments the way it is designed to 60% on the posterior aspect, 40% on the anterior aspect. So how do we do that? We do that by reinforcing a normal cervical curve, and one of the ways that we do it in our office. We use C dp.
We use chiropractic biophysics. We use the compression extension, compression chairs, the cabali to George chairs. We use the posture pump. We use traction at home for our patients. We use the dental rolls, so lots of different ways. We even used the Peton every different way. That helps to restore that cervical curve is going to make a very positive impact for the patient who has had a compression fracture.
So typically after someone’s been involved in a car accident, we’re going to see them three, maybe four, sometimes even five times a week, depending on the level of injury. Now I want to know the mechanism of the injury, and it’s important for you to know that because if they were sitting perfectly straight facing forward and they got bumped forward and they did one of these, that’s one type of injury.
But if they were turning. Or looking at the passenger, or they were the passenger sitting in an awkward position that’s going to really affect the damage that was done. So think about the position that the patient was in when they were injured. If it was a football injury, if it was a sports related injury, if it was that they got hit in the head with a softball.
Understand the mechanism of injury so that you can look at their spine and put two and two together and say, ah, this makes sense. This is why we’re seeing compression fractures here and here is what we need to do about it. I’m a big fan of being able to educate our community, and I think it’s important as chiropractors that we deliver a message that makes sense to people in a way that they can connect with and in a way that they can really understand the implications and the long-term effects.
Of their healthcare decisions. So making sure that they have the information they need by showing them their x-rays and explaining the compression fracture, and usually using simple visual tools that can help them understand that’s one way for patients to better connect with your report so that they can understand what’s really going on with their body and it can help them to understand this is not just about feeling better.
This is about. Functioning better. This is about allowing your body to heal. It’s not about pain. It’s about the brain. It’s not about the feel, it’s about the function. Whatever terminology works for you, make sure that you’re communicating it in a way that patients can understand. Symptoms are going to come and go.
That’s not an indicator of health. And in our office we typically say that symptoms are the last thing to show up, and it’s usually the first thing to go away. But we’re, what we’re looking for is a correction, removal of the interference of the nervous system, removal of the subluxation, correction of the normal cervical curve, correction of the spinal alignment throughout the entire spine.
And correction of all of the flow of the mental impulses in our office, we use nerve scans so we can show the function of the nervous system, and we use x-rays so that we can show the structure of the nervous system. Now, everybody does things differently, but I wanted to share with you some of the tools that I use in my office to help educate patients so that hopefully you can recognize those compression fractures, have a better conversation with your patients and deliver.
A good recommendation for care so that ultimately the patient can experience a greater level of health. And that’s what it’s all about. That’s what we’re here for. So ladies, I wanna take this moment to tell you that if you learn something today, thank you so much for watching. Let me know, share it with somebody else, and.
Make sure that you let ChiroSecure know that this was helpful for you. And one of the things that I love to do is I love to help professionals entrepreneurs, and of course our chiropractic women see more within themselves. Let go of any limiting beliefs you may have and create strategies so that you can achieve your lifestyle, speaking business and leadership goals.
So if you’ve ever felt stuck, if you’ve ever been bored or frustrated with your life, or you’re just not happy with your current situation. Or maybe you feel like there’s something more out there. Reach out to me. Let’s talk. Sometimes all it takes is a fresh perspective from someone on the outside and a little creativity to develop new strategies that can get you headed in your next best direction.
So if there’s something I can do to be of service to you, please don’t hesitate to reach out to me. I love to help other women succeed and achieve their goals. So I just wanna take this time to say what you are doing in your office every day with your patients. Matters, the lives that you’re changing matter, not just to the patients that you’re seeing.
But to everyone they’re connected to their families, to their coworkers, to the people in their community that they interact with on a day-to-day basis at organizations or churches or schools or meetings. What you are doing makes a difference and just. Remember that each day as you walk into your office, that you are there to serve your people so that they can experience a greater level of health.
And I know that you’re doing a great job in your office. I’m so thankful that you’re here with this community at Empowering Women in Chiropractic, so that together we can continue to bring chiropractic to the masses and fully realize the big idea. So I wanna thank you so much for joining me today. Get in touch with me.
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