Fracture risk increases with age, with four in 10 white women older than 50 years expe. Pdf burst fractures of the fifth lumbar vertebra are rare, and there are only a few. Evidencebased management of traumatic thoracolumbar burst. Twentythree patients with burst fracture of the thoracolumbar and lumbar spine were treated nonoperatively. Ideally, it should effectively correct the deformity, induce neurological recovery, allow early mobilization and return to work. Nonoperative treatment with early mobilisation without external support. Burst fractures can occur with different radiological images after high energy. Management of burst fractures in the thoracolumbar spine. Management of burst fractures in the thoracolumbar spine ncbi.
The management of thoracolumbar burst fractures remains challenging. Surgical treatment of fractures and dislocations of the thoracic and. This article focuses on fractures of the thoracic spine midback and lumbar spine lower back that result from a highenergy event, such as a car crash or a fall from a ladder. When chronic pain from a spinal compression fracture persists despite rest, activity modification, back bracing, and pain medication. The vertebral arch is a ringshaped section that forms the roof of the spinal canal and protects the spinal cord. These types of fractures are typically medical emergencies that require urgent treatment. Continued surgical treatment for spinal compression fractures. Any injury that changes the shape of a lumbar vertebra will alter the lumbar posture, increasing or decreasing the lumbar curve. Spinal burst fractures are frequent lesions, most often located at the thoracolumbar hinge been et al. Diagnosis and management of vertebral compression fractures. Percutaneous management of thoracolumbar burst fractures. Decisionmaking in burst fractures of the thoracolumbar. Pdf management of burst fractures in the thoracolumbar spine.
In general, a stable burst fracture is one in which there is no neurologic injury, in which the angulation of the spine is less than 20 degrees and in which the amount of spinal canal compromise is less than 50 percent. Fractures above l1 can be associated by spinal cord compression symptoms. Operative compared with nonoperative treatment of a. The most common fractures in the spine take place in the. Fractures of the thoracic and lumbar spine orthoinfo aaos. Among these 23 patients, had a neurological deficit and 10 patients did not have. A stable burst fracture may be treated without surgery.
The definition of a fracture is a complete or partial interruption of the continuity of the bone. Burst fracture the spine hospital at the neurological. In these patients, treatment with a brace may lead to an excellent result. A case of burst fracture of lumbar vertebrae sustained during a helicopter accident is discussed along with the aeromedical. You can feel the spinous process, a projection from this arch, when. A burst fracture is a type of traumatic spinal injury in which a vertebra breaks from a highenergy axial load, with pieces of vertebra shattering into. Management of thoracolumbar fractures thieme connect. We help you diagnose your thoracic and lumbar trauma case and provide detailed descriptions of how to manage this and hundreds of other pathologies. Nonoperative management most fractures in most fractures in thoracolumbarthoracolumbar lumbar region lumbar region consist of compression, burst fractures, and consist of compression, burst fractures, and isolated dorsal column fractures isolated dorsal column fractures stable stable fxsfxs. The lumbar spine provides stability and support for the whole upper body. A burst fracture is an injury in which the vertebra, the primary bone of the spine, breaks in multiple directions. Pdf classification of radiological changes in burst. The full text of this article is available in pdf format.