Thoracic/Lumbar Fractures Flashcards
What is the most common fracture of the thoracic/lumbar region?
Compression
What mechanism of injury is associated with compression fractures of the lumbar and thoracic spine?
Flexion
What is the 2nd most common fracture of lumbar region?
Transverse process
Is the anterior or posterior body height affected by compression fractures?
Anterior (posterior portion maintained)
For how long are the zone of impaction and step defect usually visible following compression fractures?
2 months (acute phase)
What is another name for the zone of impaction?
Zone of condensation
What condition represents avascular necrosis/progressive collapse of the vertebra following a compression fracture?
Kummel’s disease
What are the four things that can be a SOL?
1 blood 2 pus 3 edema 4 tumor
What is usually the cause of a paraspinal line deflection seen on the AP view?
SOL
What change in the pedicle region can be seen with a compression fracture on the AP view?
Intrapedicular widening
Osteoporotic compression fractures are more common after what age and in what gender?
50, females
What is the most common location for osteoporotic compression fractures?
Mid thoracic and thoracolumbar spine
What is the term for the increased kyphosis seen with osteoporosis following compression fractures?
Dowager’s hump
What is the cause of the change in appearance of the vertebral bodies after osteoporosis on imaging?
Decreased horizontal trabeculae
What is different between a pathological and regular compression fracture?
Pathological ones have decrease height of the ENTIRE vertebral body
What procedures can be done for osteoporotic compression fractures?
Vertebroplasty, kyphoplasty (cement mixture insert)
Can we adjust patients following kyphoplasty?
Yes; be aware of it on imaging
Burst fractures do not occur in what region of the spine and why?
Thoracic region (rib protection, decreased movement)
What is the major X-ray finding for burst fractures of the lumbar spine?
Posterior body convexity
Why are burst fractures in the lumbar spine so serious?
50% cause cord injury
How can a burst fracture cause cord issues?
Posterior wall blows out into canal
Why do chance fractures occur less today?
Seatbelts now have shoulder strap
What kind of mechanism of injury is associated with chance fractures?
Flexion distraction
What is a chance fracture?
Horizontal splitting of the arch and body
What is the most common location of a chance fracture?
L1-L3
What is another name for a chance fracture?
Lap belt fracture
What X-ray sign is associated with chance fractures?
Empty vertebra sign
Chance fractures are commonly associated with what other fracture?
Compression
What causes transverse process fractures?
Direct trauma or avulsion
What are the most common areas for transverse process fractures in the lumbars?
L2 and L3
What is unique about the distribution of transverse process fractures?
Usually unilateral and multi-level
Why are transverse process fractures usually hard to see on X-ray?
Obscured by gas and fecal material
Damage to what organ is associated with transverse process fractures?
Kidneys (possible renal failure to do laceration)
What sign could be associated with transverse process fractures?
Hematuria
How can we tell a burst fracture from a compression fracture?
Posterior wall blow out showing posterior margin convexity
