Management of thoracolumbar spine fractures

The Spine Journal : Official Journal of the North American Spine Society
Kirkham B WoodAvraam Ploumis

Abstract

Traumatic fractures of the spine are most common at the thoracolumbar junction and can be a source of great disability. To review the most current information regarding the pathophysiology, injury pattern, treatment options, and outcomes. Literature review. Relevant articles, textbook chapters, and abstracts covering thoracolumbar spine fractures with and without neurologic deficit from 1960 to the present were reviewed. The thoracolumbar spine represents a unique system from a skeletal as well as neurological standpoint. The rigid rib-bearing thoracic spine articulates with the more mobile lumbar spine at the thoracolumbar junction (T10 - L2), the site of most fractures. A complete examination includes a careful neurologic examination of both motor and sensory systems. CT scans best describe bony detail while MRI is most efficient at describing soft tissues and neurological structures. The most recent classification system is that of the new Thoracolumbar Injury Classification and Severity Score. The different fracture types include compression fractures, burst fractures - both stable and unstable -, flexion-distraction injuries and fracture dislocations. Their treatment, both operative and non-operative depends on the degree ...Continue Reading

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Citations

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