Thoracic and lumbar compression fractures

Background

• Also known as a "wedge fracture"
• Only unstable if posterior ligament complex ruptures (requires a rotational force)
• Unlikely to cause cord damage

Vertebral fractures and dislocations types

Vertebral anatomy.

Numbering order of vertebrae.

• Cervical fractures and dislocations
  • Atlanto-occipital dissociation
  • C1
    • Jefferson fracture
    • C1 isolated anterior arch fracture
    • C1 isolated posterior arch fracture
  • C2
    • Odontoid fracture
    • Hangman's fracture
  • C3-C7
    • Cervical burst fracture
    • Cervical spinous process fracture
    • Extension cervical teardrop fracture
    • Flexion cervical teardrop fracture
    • Anterior cervical wedge fracture
  • Cervical facet dislocation
  • Isolated transverse process fracture
• Thoracic and lumbar fractures and dislocations
  • Chance fracture
  • Thoracic burst fracture
  • Lumbar burst fracture
  • Isolated transverse process fracture
  • Thoracic and lumbar compression fractures

Clinical Features

• Mechanism: axial loading and flexion

Evaluation

Compression fracture of the fourth lumbar vertebra post falling from a height.

X-ray of the lumbar spine with a compression fracture of the third lumbar vertebra.

Diagnosis

• Suspect instability and obtain CT if:
  • Severe compression (>50% loss of vertebral height)
  • Kyphosis >30deg
  • Rotational component to injury
  • Compression fracture at multiple sites
  • Posterior cortex abnormality

See Also

• Anterior cervical wedge fracture