Spinal bruise: code according to ICD-10
ICD-10 is a system of codes for designating various pathologies. The code is assigned depending on the nature of the damage, the effect on internal organs, the possibility of complications, etc.
Cervical
Contusions of the cervical spine in ICD-10 are designated by code S14.0 , which indicates contusion and swelling of the cervical spinal cord.
Thoracic department
To designate thoracic contusions, the code used is S24.0 , which stands for “swelling and contusion of the thoracic spinal cord.”
Lumbar
As for lumbar contusions, they are presented in ICD-10 under code S34.1 - other injuries of the lumbar spinal cord.
S30—S39 Injuries to the abdomen, lower back, lumbar spine and pelvis
S30 Superficial injury to the abdomen, lower back and pelvis
- S30.0
Contusion of the lower back and pelvis - S30.1
Abdominal wall contusion - S30.2
Contusion of the external genitalia - S30.7
Multiple superficial injuries of the abdomen, lower back and pelvis - S30.8
Other superficial injuries of the abdomen, low back and pelvis - S30.9
Superficial injury of the abdomen, lower back and pelvis, unspecified location
S31 Open wound of the abdomen, lower back and pelvis
- S31.0
Open wound of the lower back and pelvis - S31.1
Open wound of the abdominal wall - S31.2
Open wound of the penis - S31.3
Open wound of the scrotum and testicles - S31.4
Open wound of vagina and vulva - S31.5
Open wound of other and unspecified external genitalia - S31.7
Multiple open wounds of the abdomen, lower back and pelvis - S31.8
Open wound of another and unspecified part of the abdomen
S32 Fracture of the lumbosacral spine and pelvic bones
- S32.00
Fracture of the lumbar vertebra, closed - S32.01
Open lumbar vertebra fracture - S32.10
Sacral fracture, closed - S32.11
Open sacral fracture - S32.20
Closed coccyx fracture - S32.21
Open coccyx fracture - S32.30
Ilial bone fracture, closed - S32.31
Open ilium fracture - S32.40
Acetabular fracture, closed - S32.41
Open acetabulum fracture - S32.50
Closed pubic bone fracture - S32.51
Open pubic bone fracture - S32.70
Multiple fractures of the lumbosacral spine and pelvic bones, closed - S32.71
Multiple open fractures of the lumbosacral spine and pelvic bones - S32.80
Fractures of other and unspecified parts of the lumbosacral spine and pelvic bones, closed - S32.81
Open fractures of other and unspecified parts of the lumbosacral spine and pelvic bones
S33 Dislocation, sprain and overstrain of the capsular-ligamentous apparatus of the lumbar spine and pelvis
- S33.0
Traumatic rupture of the intervertebral disc in the lumbosacral region - S33.1
Dislocation of the lumbar vertebra - S33.2
Dislocation of the sacroiliac joint and sacrococcygeal joint - S33.3
Dislocation of other and unspecified part of the lumbosacral spine and pelvis - S33.4
Traumatic rupture of the pubic symphysis [symphysis pubis] - S33.5
Stretching and overstrain of the capsular-ligamentous apparatus of the lumbar spine - S33.6
Sprain and strain of the capsular-ligamentous apparatus of the sacroiliac joint - S33.7
Sprain and strain of the capsular-ligamentous apparatus of another and unspecified part of the lumbosacral spine and pelvis
S34 Injury to nerves and lumbar spinal cord at the level of the abdomen, lower back and pelvis
- S34.0
Concussion and swelling of the lumbar spinal cord - S34.1
Other lumbar spinal cord injury - S34.2
Nerve root injury of the lumbosacral spine - S34.3
Cauda equina injury - S34.4
Injury to the lumbosacral nerve plexus - S34.5
Injury to lumbar, sacral and pelvic sympathetic nerves - S34.6
Peripheral nerve injury to the abdomen, lower back and pelvis - S34.8
Injury to other and unspecified nerves at the level of the abdomen, lower back and pelvis
S35 Injury to blood vessels in the abdomen, lower back and pelvis
- S35.0
Injury to the abdominal aorta - S35.1
Injury to the inferior vena cava - S35.2
Injury to the celiac or mesenteric artery - S35.3
Portal or splenic vein injury - S35.4
Injury to blood vessels of the kidney - S35.5
Injury to iliac blood vessels - S35.7
Injury to multiple blood vessels in the abdomen, lower back and pelvis - S35.8
Injury to other blood vessels in the abdomen, lower back and pelvis - S35.9
Injury to unspecified blood vessel at the level of the abdomen, lower back and pelvis
S36 Abdominal trauma
- S36.00
Injury to the spleen without an open wound into the abdominal cavity - S36.01
Injury to the spleen with an open wound into the abdominal cavity - S36.10
Injury to the liver and gall bladder without an open wound to the abdominal cavity - S36.11
Injury to the liver and gall bladder with an open wound into the abdominal cavity - S36.20
Trauma to the pancreas without an open wound into the abdominal cavity - S36.21
Trauma to the pancreas with an open wound into the abdominal cavity - S36.30
Stomach injury without open wound into the abdominal cavity - S36.31
Stomach injury with open wound into the abdominal cavity - S36.40
Injury to the small intestine without an open wound into the abdominal cavity - S36.41
Injury of the small intestine with an open wound into the abdominal cavity - S36.50
Colon injury without open wound into the abdominal cavity - S36.51
Colon injury with open wound into the abdominal cavity - S36.60
Rectal injury without open wound into the abdominal cavity - S36.61
Injury to the rectum with an open wound into the abdominal cavity - S36.70
Injury of several intra-abdominal organs without an open wound into the abdominal cavity - S36.71
Injury of several intra-abdominal organs with an open wound into the abdominal cavity - S36.80
Injury to other intra-abdominal organs without an open wound into the abdominal cavity - S36.81
Injury to other intra-abdominal organs with an open wound into the abdominal cavity - S36.90
Injury of unspecified intra-abdominal organ without open wound to the abdominal cavity - S36.91
Injury to an unspecified intra-abdominal organ with an open wound into the abdominal cavity
S37 Trauma to the pelvic organs
- S37.00
Kidney injury without open wound into the abdominal cavity - S37.01
Kidney injury with open wound into the abdominal cavity - S37.10
Trauma to the ureter without an open wound into the abdominal cavity - S37.11
Trauma to the ureter with an open wound into the abdominal cavity - S37.20
Bladder injury without open wound to the abdominal cavity - S37.21
Bladder injury with open wound into the abdominal cavity - S37.30
Trauma to the urethra without an open wound into the abdominal cavity - S37.31
Trauma to the urethra with an open wound into the abdominal cavity - S37.40
Trauma to the ovary without an open wound into the abdominal cavity - S37.41
Trauma to the ovary with an open wound into the abdominal cavity - S37.50
Injury of the fallopian tube without open wound to the abdominal cavity - S37.51
Injury of the fallopian tube with an open wound into the abdominal cavity - S37.60
Trauma to the uterus without an open wound into the abdominal cavity - S37.61
Injury of the uterus with an open wound into the abdominal cavity - S37.70
Injury of several pelvic organs without an open wound into the abdominal cavity - S37.71
Injury of several pelvic organs with an open wound into the abdominal cavity - S37.80
Injury to other pelvic organs without open wound to the abdominal cavity - S37.81
Injury to other pelvic organs with an open wound into the abdominal cavity - S37.90
Injury of unspecified pelvic organ without open wound to the abdominal cavity - S37.91
Injury of unspecified pelvic organ with open wound to the abdominal cavity
S38 Crushing and traumatic amputation of part of the abdomen, lower back and pelvis
- S38.0
Crushing of external genitalia - S38.1
Crushing of other and unspecified parts of the abdomen, lower back and pelvis - S38.2
Traumatic amputation of external genitalia - S38.3
Traumatic amputation of other and unspecified part of the abdomen, lower back and pelvis
S39 Other and unspecified injuries of the abdomen, lower back and pelvis
- S39.0
Injuries to muscles and tendons of the abdomen, lower back and pelvis - S39.6
Combined injury of intra-abdominal and pelvic organs - S39.7
Other multiple injuries of the abdomen, lower back and pelvis - S39.8
Other specified injuries of the abdomen, lower back and pelvis - S39.9
Injury to the abdomen, lower back and pelvis, unspecified
Causes and risk factors
Spinal contusions are found in 10% of people with musculoskeletal injuries. Most often they are observed in representatives of the stronger sex aged 35-50 years. As for children and the elderly, injuries of this kind are rare.
According to statistics, in 40% of cases the lower thoracic vertebrae and the first lumbar vertebrae are affected, in 35% of cases - the vertebrae of the neck, and in the remaining 25% of cases - the remaining vertebrae.
The vertebrae most often injured are the lower back and neck.
In most cases (up to 65%), spinal bruises occur in people involved in a traffic accident.
The etiology of a bruise of the spine and tissues located around it is multifaceted, but most often injuries occur due to:
- fights;
- car accidents;
- jumping from great heights;
- blows to the back with heavy objects;
- improper performance of exercises when playing sports;
- diving into water (due to hitting the bottom of a reservoir or the surface of the water);
- household injuries (falling from a ladder or from a chair);
- loss of consciousness and further falling on the back.
Symptoms of a spinal bruise
Most often, patients with spinal bruises complain of pain . Unpleasant sensations may vary depending on intensity and location. Often, along with pain, disturbances in motor activity and sensitivity are observed.
| Contusion of the cervical spine is accompanied by: |
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| Contusion of the thoracic spine: |
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| Lumbar contusion: |
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| Bruise of the sacrum, coccyx: |
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With bruises of the cervical spine, a violation of the anatomical location of the vertebrae may be observed. Such injuries are severe, unstable and require immediate medical attention.
Consequences
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Next fact
A spinal bruise can lead to disruption of functional activity. Complications of a spinal bruise include disturbances in the functioning of the body that could not be eliminated during treatment of the injury.
The consequences of bruises include:
- disturbances in the processes of urination and defecation;
- motor dysfunction – paresis and paralysis;
- reduction/loss of sensitivity of the skin area;
- problems in the intimate sphere;
- coma (in severe cases).
Please pay attention to the following articles:
- You can study the symptoms and consequences of a spinal fracture at this link
- More information about compression fractures of the lumbar vertebra can be found on the page
- How is a compression fracture in the thoracic spine treated and what are the consequences?
- Rules for first aid and transportation for a spinal fracture are here
Spinal bruise
Spinal contusion without spinal cord damage
There is no breath holding at the time of injury.
A patient with a spinal bruise is bothered by back pain, which intensifies with active movements, standing and walking. On examination, local swelling, redness or cyanosis is revealed. Sometimes hematomas form. Muscle tension and local pain in the area of the bruise are determined by palpation. Pressure on the spinous processes is painless or accompanied by minor pain due to damage to the superficial soft tissues. To exclude a spinal fracture, x-rays are prescribed. In doubtful cases, a CT scan of the spine or MRI is additionally used. If minor neurological disorders are suspected, the patient is referred for examination to a neurologist or neurosurgeon. Treatment is carried out by a traumatologist at the emergency room. The patient is recommended to rest in bed. To unload the spine, it is better to sleep on a hard surface (you can place a wooden board under the mattress) with a bolster under the lumbar area.
In the first days, it is recommended to apply cold to the affected area, except in cases where the bruise is located in the projection of the kidney. Subsequently, UHF is prescribed, it is recommended to apply dry heat to the area of \u200b\u200bthe bruise, and use absorbable and warming ointments. The outcome is usually favorable, all symptoms of the bruise disappear within a few weeks. In some cases, the development of post-traumatic osteochondrosis is possible.
Spinal contusion with spinal cord injury
Such bruises more often occur with high-energy injuries (falls from a height, accidents, rubble, jumping into water upside down, etc.). At the moment of injury, sharp pain appears. The nature of neurological disorders depends on the location of the injury. With bruises of the cervical spine, ptosis, constriction of the pupils and pathological dryness of the face can be detected. In some cases (when the brain stem is involved in the process), cardiac dysfunction, swallowing disorders and hiccups are observed.
Possible respiratory disorders: difficulty breathing or forced breathing using the muscles of the neck, chest and back. With severe contusions of the spinal cord, respiratory arrest and death develop. Depending on the severity of the spinal cord injury, tetraplegia, tetraparesis, or mild limb weakness combined with sensory disturbances may occur. When the upper cervical vertebrae are affected, spastic paralysis of all four limbs occurs; when the lower ones are affected, spastic paralysis of the lower extremities and flaccid paralysis of the upper extremities occur. Reflexes are reduced or absent.
Contusions of the thoracic spine with concussion or contusion of the spinal cord are manifested by conduction-type sensory disturbances in combination with paralysis, paresis or weakness of the lower extremities. Abdominal reflexes decrease or disappear. Cardialgia is possible. There are dysfunctions of the pelvic organs of varying severity. Contusions of the lumbar spine are accompanied by flaccid paralysis of certain areas of the lower extremities and sensory disturbances (the upper limit of motor and sensory disturbances depends on the level of damage to the spinal cord). Dysfunction of the pelvic organs may be observed. Early development of bedsores is characteristic. Cystitis often occurs.
At the prehospital stage, spinal contusion cannot be differentiated from more severe injuries, including unstable spinal fractures. Therefore, when providing first aid, one must proceed from the fact that any movement can lead to a deterioration in the victim’s condition and aggravation of neurological symptoms. Under no circumstances should the patient be put on his feet, asked to sit down, roughly moved, bent torso, etc.
If during transportation it is possible to lay the victim on a hard surface (for example, on a wooden panel or a door removed from its hinges), he should be carefully moved there and placed on his back, trying to disturb the spine as little as possible. If the only available means of transportation is a stretcher, the patient is placed on his stomach, trying to first level the surface of the stretcher with blankets or folded clothing. In this case, you need to ensure that the victim’s back remains straightened.
The patient is placed on a stretcher or shield by three people, simultaneously holding him by the head, chest, lower back, pelvic area and knee joints, and then tied to the transport vehicle using wide belts or tapes. Before moving, the victim is given painkillers. If the cervical spine is damaged, the neck is immobilized using a special collar or thick fabric folded in several layers.
After these measures are carried out, the patient is urgently taken to the trauma, nervous or neurosurgical department for further examination and treatment. The examination plan includes x-rays of the spine, a detailed neurological examination, spinal tap, MRI of the spine, myelography and other studies. Treatment is carried out in a hospital setting.
The patient is placed on a bed with a shield. To improve blood supply and stimulate neurons, methylprednisolone is prescribed. Painkillers, diazepam, phenytoin and vitamin E are used. Physiotherapeutic procedures and exercise therapy are used. Measures are taken to prevent bedsores and infectious lesions of the genitourinary system. At the end of the acute period, rehabilitation measures are carried out; if necessary, patients are sent to specialized centers and sanatoriums.
For spinal cord concussions, the outcome is complete recovery. In the case of a bruise, the prognosis is less favorable - with minor injuries, disturbances in movement and sensitivity disappear within 4-5 weeks, but the rehabilitation period can take up to six months or more. In the long-term period after severe bruises, residual effects (paralysis, paresis, loss of sensitivity) can persist throughout life.
Treatment
A qualified specialist should make a decision on how to treat a spinal bruise after a complete diagnosis, including X-ray or MRI. If a person is found to have compression fractures, damage or compression of nerve structures, displacement of vertebral bodies or intervertebral discs, he is admitted to a hospital.
First aid
In order for the bruise to be treated as quickly as possible, the patient must be given first aid.
You can do this as follows:
- Call an ambulance. You cannot move or lift a person. The victim should remain stationary (this will prevent the injury from worsening).
- If the injury is localized in the neck area, this part of the spine must be fixed using a special orthopedic collar or a homemade splint (for example, from a bandage and cotton wool).
- In the absence of breathing, artificial ventilation of the lungs is necessary. In this case, the victim must remain motionless.
- When swelling forms, cold is applied to the affected area of the body.
- The ambulance crew that arrived at the scene takes the person to the hospital. To do this, the victim is placed on a soft stretcher face down or on a hard stretcher face up. This allows you to create maximum immobility for the damaged area of the spine.
Drugs
The following medications can be used to treat spinal bruises::
| Anticoagulants | to reduce the likelihood of blood clots |
| Nootropics and anabolics | for accelerated wound healing, activation of nervous activity, normalization of protein metabolism |
| Angioprotectors | to dilate blood vessels, increase their resistance |
| Antibacterial drugs | for the treatment of post-traumatic infections and inflammations |
| Neuroleptics, antidepressants, sedatives | to improve the mental state of patients with severe injuries |
If a spinal bruise has immobilized the patient, prolonged lying in the “lying down” position can cause bedsores.
This unpleasant phenomenon must be dealt with in a timely manner: if the wounds become deep, they can only be gotten rid of surgically. To eliminate bedsores, drugs such as Levomekol, Chlorhexidine, Solcoseryl and others can be used.
To improve the condition of ligaments and muscles with bruises, you can use gels and ointments with anti-inflammatory and analgesic effects. These include drugs such as Diclofenac, Troxevasin, Sedalgin, Lyoton, Ibuprofen, Pentalgin, Heparin ointment, etc.
Video: “What to do if you have a spinal injury?”
Surgery
Surgical treatment of spinal bruises is carried out in the most severe cases.
Indications for surgical intervention are:
- absence of complete transverse lesion of the spinal cord;
- preservation of at least weak function of the spinal cord when it is compressed;
- preservation of symptoms of the nerve roots (there is a chance of restoring patency when they are sutured);
- the presence of severe deformation of the spinal column, interfering with the patient’s rehabilitation.
It is important to understand that restoring motor activity after severe spinal bruises is quite difficult. This process can take much longer than the treatment itself.
Exercise therapy and massage
You can engage in exercise therapy and take gentle massage courses starting from the 10th day of treatment.
Exercise therapy and massage for spinal injuries are done only on the 10th day after the injury. A set of physical exercises must be selected by the attending physician.
Only in this case can you count on restoration of the motor functions of the spinal column and the absence of complications caused by improper or excessive load.
As for massage procedures, all means are good in the fight against bruises.
It is allowed to use classic types of massage (manual exposure) and hardware (exposure to air flows, water, vibration).
All procedures must be performed by a qualified professional.
Treatment at home
You can treat bruises at home using the following recipes::
- Brew 200 g of dried mint with boiling water, add the infusion to the bath. Lie in “mint” water for 20 or 30 minutes.
- Mix 120 ml of six percent vinegar and 1/2 teaspoon of salt. Soak a clean cotton cloth in the prepared solution and apply it to the bruised area for 20-30 minutes.
- Boil the beans, pass through a meat grinder and apply to the damaged area of the spine. Secure the compress with a bandage and leave overnight.
- Make a tincture from 100 grams of hop cones and 0.4 liters of vodka. Soak a cloth in the infusion, apply it to the injured area, and wrap it with a scarf.
Bruise of the coccyx, sacrum causes, symptoms, methods of treatment and prevention
Depending on the severity of the injuries, mild and severe injuries are distinguished; their symptoms differ.
Minor injuries
Characterized by the absence of pain at rest. Discomfort occurs only when pressing on the bruise site. A distinctive feature of a small bruise of the sacrum or coccyx is that after a long stay in a standing position, it is difficult for the patient to sit down, but when sitting, the discomfort gradually disappears. It is also difficult for the patient to get up if he has been sitting for several hours before. In the area of impact there is swelling and redness of the skin.
Severe injuries
Characterized by painful sensations even at rest. The syndrome radiates to the perineum, reproductive and urinary system organs. The mobility of joint tissues in the pelvic area is difficult. When moving, the pain sharply worsens. Defecation is also accompanied by discomfort, due to attachment to the coccyx, which are involved in straining. When occupying a sitting or lying position, the painful sensations do not disappear.
Severe injury is often characterized by the formation of hematomas between muscle tissue. Immediately after the injury, the pain subsides and occurs after a certain period of time. Another manifestation of a severe bruise of the tailbone or sacrum is delayed urination or frequent urination. In case of injury to the pelvic organs, doctors identify the following signs:
- in case of injury to the bladder, the patient experiences impurities of blood cells in the urine, the urination process is accompanied by severe discomfort, the patient complains of constant aching pain in the genital area;
- bruising of the tailbone or sacrum can damage the uterus. A characteristic symptom is bleeding from the vagina. There is also aching painful sensations, accompanied by a feeling of vaginal distension;
- damage to the tissues of the rectum is characterized by constant painful sensations, admixtures of blood cells in the stool, stagnation of feces is possible;
- injury to the nerve endings that emerge from the foramina of the sacrum. In rare cases, there may be a disturbance in the sensitivity of the lower extremities, pain, and a tingling sensation.
Any internal bleeding provokes the development of anemia. The patient's temperature rises and stiffness in movements appears. It is more difficult for the patient to bend his body.