Thoracolumbar spinal fractures Flashcards
how do the majority of thoracolumbar spinal fractures occur
due to motor vehicle accidents or falls from height
describe the different type of thoracolumbar fracture that can occur in the elderly
in elderly with osteoporosis, osteoporotic insufficiency wedge fracture can occur, usually only needs symptomatic treatment
what management is given for any high energy thoracolumbar require
full trauma evaluation and neurological assessment
what other pathology are thoracolumbar injuries often associated with (15-20% cases)
neurological deficit
what type of thoracolumbar fractures are seen in high energy trauma in young patients
‘burst’ fractures with posterior involvement, or ‘chance’ flexion-distraction fracture
describe what happens with a ‘chance’ flexion-distraction fracture
failure of posterior ligaments, may be unstable and require operative stabilisation
how may more stable fractures involving the thoracic spine be treated
with brace to limit flexion and prevent kyphosis
how may more stable fractures involving the lumbar spine be treated
with a plaster jacket to preserve lumbar lordosis
how is posterior bony or ligamentous injury detected in thoracolumbar injury
localised tenderness, swelling or palpable defect on examination
what are some indications for surgery in a thoracolumbar fracture
presence of neurological deficit especially if progressive or very unstable, or unstable injury pattern
what is meant by an unstable injury pattern
substantial loss of vertebral height, displacement or involvement of posterior ligamentous structures
what may be involved in surgical treatment for thoracolumbar fractures
stabilisation wit pedicle screws and rods, spinal fusion and decompression in presence of neurological deficit
