Fractures of the thoracic and Lumbar spine are characterised by their mechanism of injury and severity. Numerous classification systems exist.
Some include the presence or otherwise of neurological injury and soft tissue injury.
The more severe the patient's overall injury, the greater the likelihood of injury to other organ systems and the need for emergency care.
Thoracic and Lumbar spine Fracture can result in significant spinal cord or nerve injury.
Types of Fracture:
- Compression Wedge Fractures are those where the front of the vertebra is crushed to a great or lesser degree, whereas the back wall of the vertebral body is intact, continuing to protect the spinal cord and nerves. Usually mechanically stable and has a low likelihood of neurological injury.
- Compression Burst Fractures involve crushing the front and back of the vertebral body, endangering the spinal cord and nerves and mechanical stability of the spine, depending upon the severity of the injury and degree of soft tissue injury. They are often caused by landing on the feet after falling from a significant height. Patients can have significant neurological injuries.
- Flexion/distraction (Chance) fracture. The vertebrae are suddenly levered apart. It was previously called a Seatbelt Pattern Injury. These fractures can occur in violent head-on car collisions when the body is thrown forward whilst the seat belt stabilises the pelvis. This results in a combined soft tissue ligament tearing injury and bony fracturing, resulting in an unstable fracture.
- Fracture-dislocation Fractures. Dramatic and severe injuries resulting from high-energy trauma often result in neurological injury and clear instability.
Suspected spinal injury patients are investigated with X-ray, CT and, when stable, MRI scanning to characterise these injuries fully.
