Thoracic and lumbar compression fractures: Difference between revisions

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====[[Thoracic and lumbar fractures]] (wedge)====
==Background==
*Also known as a "wedge fracture"
*Only unstable if posterior ligament complex ruptures (requires a rotational force)
*Only unstable if posterior ligament complex ruptures (requires a rotational force)
*Unlikely to cause cord damage
{{Vertebral fractures and dislocations types}}
==Clinical Features==
*Mechanism: axial loading and flexion
*Mechanism: axial loading and flexion
*Unlikely to cause cord damage
 
==Differential Diagnosis==
{{Thoracic trauma DDX}}
{{Lower back pain DDX}}
 
==Evaluation==
[[File:L4 compressionFracture2008.jpg|thumb|Compression fracture of the fourth lumbar vertebra post falling from a height.]]
[[File:Compressionfracture.jpg|thumb|X-ray of the lumbar spine with a compression fracture of the third lumbar vertebra.]]
[[File:T12compressionfracMark.png|thumb|Compression fracture of T12.]]
===Workup===
 
===Diagnosis===
*Suspect instability and obtain CT if:
*Suspect instability and obtain CT if:
**Severe compression (>50% loss of vertebral height)
**Severe compression (>50% loss of vertebral height)
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**Compression fracture at multiple sites
**Compression fracture at multiple sites
**Posterior cortex abnormality
**Posterior cortex abnormality
==Management==
*Nonoperative:orthosis, calcitonin, biphophanates.
*kyphoplasty
*vertebroplasty
*surgical decompression and stabilization
==Disposition==
Home if fracture stable and pain control optimal.
==See Also==
*[[Anterior cervical wedge fracture]]
==External Links==
==References==
<references/>





Latest revision as of 15:45, 27 January 2021

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.

Clinical Features

  • Mechanism: axial loading and flexion

Differential Diagnosis

Thoracic Trauma

Lower Back Pain

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.
Compression fracture of T12.

Workup

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

Management

  • Nonoperative:orthosis, calcitonin, biphophanates.
  • kyphoplasty
  • vertebroplasty
  • surgical decompression and stabilization

Disposition

Home if fracture stable and pain control optimal.

See Also

External Links

References