Difference between revisions of "Thoracic and lumbar compression fractures"

(Differential Diagnosis)
 
Line 27: Line 27:
  
 
==Management==
 
==Management==
 
+
*Nonoperative:orthosis, calcitonin, biphophanates.
 +
*kyphoplasty
 +
*vertebroplasty
 +
*surgical decompression and stabilization
  
 
==Disposition==
 
==Disposition==
 
+
Home if fracture stable and pain control optimal.
  
 
==See Also==
 
==See Also==

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.

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