eMedicine Specialties > Orthopedic Surgery > Spine
Lumbar Spine Fractures and Dislocations: Multimedia
Updated: Jan 8, 2009
Multimedia
 | Media file 1: A 42-year-old man fell from a tree. He arrived at the hospital with a complete paraplegia. Plain radiographs reveal a fracture of L2 with L2-L3 subluxation. |
 | Media file 2: CT scan of a 42-year-old man who fell from a tree. He arrived at the hospital with a complete paraplegia (same patient as in Image above). Note the large amount of bone retropulsed inside the spinal canal. |
 | Media file 3: CT scan showing a burst of the L2 vertebral body. |
 | Media file 4: Postoperative lateral radiograph; although the patient was paraplegic, in order to prevent severe kyphotic deformity of the spine and to allow a rapid mobilization, a posterior arthrodesis was performed with pedicle screws, hooks, and rods. |
 | Media file 5: A 37-year-old man who underwent an anterior approach for an unstable L1 burst fracture. A corpectomy was performed, with a vertebral reconstruction with Harms cages and a screw to stabilize the cage. The patient subsequently underwent a posterior arthrodesis with iliac crest bone graft and transpedicular screw placement. |
 | Media file 6: A 52-year-old man was involved in a severe motor vehicle collision. He arrived at the hospital with severe pain but no neurologic deficit. Lateral plain radiographs show a fracture at T12. |
 | Media file 7: Sagittal T2-weighted image of a 52-year-old man who was involved in a severe motor vehicle collision. He arrived at the hospital with severe pain but no neurologic deficit (same patient as in Image 6). Image reveals a significant mass effect within the spinal canal. |
 | Media file 8: Patients with compression fractures not compromising the spinal canal can be treated by means of a kyphoplasty. The use of a percutaneous balloon allows for expansion of the fractured vertebrae. Then, the void created by the balloon is filled with bone cement |
 | Media file 9: Patients with an acute compression fracture treated with kyphoplasty. AP and lateral views demonstrate a good expansion of the compressed vertebral body and nice feeling with cement. |
 | Media file 10: A 47-year-old man was involved in a motor vehicle accident. He arrived at the hospital with paraplegia but preserved sensation in both lower extremities. He was immediately taken to surgery for an open reduction of the fracture, decompression of the cauda equine, and arthrodesis of the spine. He regained motor function following the surgery. |
More on Lumbar Spine Fractures and Dislocations |
| Overview: Lumbar Spine Fractures and Dislocations |
| Workup: Lumbar Spine Fractures and Dislocations |
| Treatment: Lumbar Spine Fractures and Dislocations |
| Follow-up: Lumbar Spine Fractures and Dislocations |
 Multimedia: Lumbar Spine Fractures and Dislocations |
| References |
| Further Reading |
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References
Hsieh CT, Chen GJ, Wu CC, Su YH. Complete fracture-dislocation of the thoracolumbar spine without paraplegia. Am J Emerg Med. Jun 2008;26(5):633.e5-7. [Medline].
Levi AD, Hurlbert RJ, Anderson P, et al. Neurologic deterioration secondary to unrecognized spinal instability following trauma--a multicenter study. Spine. Feb 15 2006;31(4):451-8. [Medline].
van der Roer N, de Bruyne MC, Bakker FC, et al. Direct medical costs of traumatic thoracolumbar spine fractures. Acta Orthop. Oct 2005;76(5):662-6. [Medline].
Kinoshita T, Ebara S, Kamimura M, et al. Nontraumatic lumbar vertebral compression fracture as a risk factor for femoral neck fractures in involutional osteoporotic patients. J Bone Miner Metab. 1999;17(3):201-5. [Medline].
Fontaine MA, Albert A, Dubois B, et al. Fracture and bone mineral density in hemodialysis patients. Clin Nephrol. Sep 2000;54(3):218-26. [Medline].
Ichikawa S, Johnson ML, Koller DL, et al. Polymorphisms in the bone morphogenetic protein 2 (BMP2) gene do not affect bone mineral density in white men or women. Osteoporos Int. Jan 24 2006;1-6. [Medline].
Kudlacek S, Schneider B, Resch H, et al. Gender differences in fracture risk and bone mineral density. Maturitas. Oct 31 2000;36(3):173-80. [Medline].
Wu CT, Lee SC, Lee ST, Chen JF. Classification of symptomatic osteoporotic compression fractures of the thoracic and lumbar spine. J Clin Neurosci. Jan 2006;13(1):31-8. [Medline].
Smith JA, Siegel JH, Siddiqi SQ. Spine and spinal cord injury in motor vehicle crashes: a function of change in velocity and energy dissipation on impact with respect to the direction of crash. J Trauma. Jul 2005;59(1):117-31. [Medline].
Beaunoyer M, St-Vil D, Lallier M, Blanchard H. Abdominal injuries associated with thoraco-lumbar fractures after motor vehicle collision. J Pediatr Surg. May 2001;36(5):760-2. [Medline].
le Roux JC, Dunn RN. Gunshot injuries of the spine--a review of 49 cases managed at the Groote Schuur Acute Spinal Cord Injury Unit. S Afr J Surg. Nov 2005;43(4):165-8. [Medline].
Franz T, Hasler RM, Benneker L, Zimmermann H, Siebenrock KA, Exadaktylos AK. Severe spinal injuries in alpine skiing and snowboarding: a 6-year review of a tertiary trauma centre for the Bernese Alps ski resorts, Switzerland. Br J Sports Med. Jan 2008;42(1):55-8. [Medline].
Sieradzki JP, Sarwark JF. Thoracolumbar fracture-dislocation in child abuse: case report, closed reduction technique and review of the literature. Pediatr Neurosurg. 2008;44(3):253-7. [Medline].
Patten RM, Gunberg SR, Brandenburger DK. Frequency and importance of transverse process fractures in the lumbar vertebrae at helical abdominal CT in patients with trauma. Radiology. Jun 2000;215(3):831-4. [Medline].
Alanay A. Re: post-traumatic findings of the spine after earlier vertebral fracture in young patients. Spine. Nov 1 2000;25(21):2847-8. [Medline].
Dogan S, Safavi-Abbasi S, Theodore N, Chang SW, Horn EM, Mariwalla NR, et al. Thoracolumbar and sacral spinal injuries in children and adolescents: a review of 89 cases. J Neurosurg. Jun 2007;106(6 Suppl):426-33. [Medline].
El Assuity WI, El Masry MA, Chan D. Acute traumatic spondylolisthesis at the lumbosacral junction. J Trauma. Jun 2007;62(6):1514-6; discussion 1516-7. [Medline].
Heyde CE, Ertel W, Kayser R. [Management of spine injuries in polytraumatized patients]. Orthopade. Sep 2005;34(9):889-905. [Medline].
Marczynski W, Kroczak S, Baranski M. Fractures of thoracic and lumbar spine; treatment and follow up. Ann Transplant. 1999;4(3-4):46-8. [Medline].
Woolard A, Oussedik S. Injuries to the lumbar spine: identification and management. Hosp Med. Jul 2005;66(7):384-8. [Medline].
Berry GE, Adams S, Harris MB, et al. Are plain radiographs of the spine necessary during evaluation after blunt trauma? Accuracy of screening torso computed tomography in thoracic/lumbar spine fracture diagnosis. J Trauma. Dec 2005;59(6):1410-3; discussion 1413. [Medline].
Croce MA, Bee TK, Pritchard E, et al. Does optimal timing for spine fracture fixation exist?. Ann Surg. Jun 2001;233(6):851-8. [Medline].
Kerwin AJ, Frykberg ER, Schinco MA, Griffen MM, Arce CA, Nguyen TQ, et al. The effect of early surgical treatment of traumatic spine injuries on patient mortality. J Trauma. Dec 2007;63(6):1308-13. [Medline].
Dosch JC, Moser T, Dupuis MG, Dietemann JL. [How to read radiography of the traumatic spine?]. J Radiol. May 2007;88(5 Pt 2):802-16. [Medline].
Groves CJ, Cassar-Pullicino VN, Tins BJ, et al. Chance-type flexion-distraction injuries in the thoracolumbar spine: MR imaging characteristics. Radiology. Aug 2005;236(2):601-8. [Medline].
Karaikovic EE, Pacheco HO. Treatment options for thoracolumbar spine fractures. Bosn J Basic Med Sci. May 2005;5(2):20-6. [Medline].
Inaba K, Kirkpatrick AW, Finkelstein J, et al. Blunt abdominal aortic trauma in association with thoracolumbar spine fractures. Injury. Apr 2001;32(3):201-7. [Medline].
Tyroch AH, McGuire EL, McLean SF, et al. The association between Chance fractures and intra-abdominal injuries revisited: a multicenter review. Am Surg. May 2005;71(5):434-8. [Medline].
Crawford CH 3rd, Puno RM, Campbell MJ, Carreon LY. Surgical management of severely displaced pediatric seat-belt fracture-dislocations of the lumbar spine associated with occlusion of the abdominal aorta and avulsion of the cauda equina: a report of two cases. Spine. May 1 2008;33(10):E325-8. [Medline].
Ball ST, Vaccaro AR, Albert TJ, Cotler JM. Injuries of the thoracolumbar spine associated with restraint use in head-on motor vehicle accidents. J Spinal Disord. Aug 2000;13(4):297-304. [Medline].
Ohana N, Sheinis D, Rath E, et al. Is there a need for lumbar orthosis in mild compression fractures of the thoracolumbar spine? A retrospective study comparing the radiographic results between early ambulation with and without lumbar orthosis. J Spinal Disord. Aug 2000;13(4):305-8. [Medline].
Al-Khalifa FK, Adjei N, Yee AJ, Finkelstein JA. Patterns of collapse in thoracolumbar burst fractures. J Spinal Disord Tech. Oct 2005;18(5):410-2. [Medline].
Lalonde F, Letts M, Yang JP, Thomas K. An analysis of burst fractures of the spine in adolescents. Am J Orthop. Feb 2001;30(2):115-20. [Medline].
Sanderson PL, Fraser RD, Hall DJ, et al. Short segment fixation of thoracolumbar burst fractures without fusion. Eur Spine J. 1999;8(6):495-500. [Medline].
Blanco JF, De Pedro JA, Hernández PJ, et al. Conservative management of burst fractures of the fifth lumbar vertebra. J Spinal Disord Tech. Jun 2005;18(3):229-31. [Medline].
Carl AL, Matsumoto M, Whalen JT. Anterior dural laceration caused by thoracolumbar and lumbar burst fractures. J Spinal Disord. Oct 2000;13(5):399-403. [Medline].
Dai LY. Remodeling of the spinal canal after thoracolumbar burst fractures. Clin Orthop. Jan 2001;(382):119-23. [Medline].
Razak M, Mahmud MM, Hyzan MY, Omar A. Short segment posterior instrumentation, reduction and fusion of unstable thoracolumbar burst fractures--a review of 26 cases. Med J Malaysia. Sep 2000;55 Suppl C:9-13. [Medline].
Elias WJ, Simmons NE, Kaptain GJ, et al. Complications of posterior lumbar interbody fusion when using a titanium threaded cage device. J Neurosurg. Jul 2000;93(1 Suppl):45-52. [Medline].
Godlewski P, Mazurkiewicz T. [Use of transpedicular fixation in treatment of thoraco-lumbar spinal injuries]. Neurol Neurochir Pol. Nov-Dec 2000;34(6):1187-95. [Medline].
Knop C, Fabian HF, Bastian L, Blauth M. Late results of thoracolumbar fractures after posterior instrumentation and transpedicular bone grafting. Spine. Jan 1 2001;26(1):88-99. [Medline].
Oishi M, Onesti ST. Electrical bone graft stimulation for spinal fusion: a review. Neurosurgery. Nov 2000;47(5):1041-55; discussion 1055-6. [Medline].
Tezeren G, Kuru I. Posterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus long-segment instrumentation. J Spinal Disord Tech. Dec 2005;18(6):485-8. [Medline].
Kim TK, Kim KH, Kim CH, et al. Percutaneous vertebroplasty and facet joint block. J Korean Med Sci. Dec 2005;20(6):1023-8. [Medline].
Pradhan BB, Bae HW, Kropf MA, et al. Kyphoplasty reduction of osteoporotic vertebral compression fractures: correction of local kyphosis versus overall sagittal alignment. Spine. Feb 15 2006;31(4):435-41. [Medline].
Verlaan JJ, van de Kraats EB, Oner FC, et al. The reduction of endplate fractures during balloon vertebroplasty: a detailed radiological analysis of the treatment of burst fractures using pedicle screws, balloon vertebroplasty, and calcium phosphate cement. Spine. Aug 15 2005;30(16):1840-5. [Medline].
Hiwatashi A, Sidhu R, Lee RK, et al. Kyphoplasty versus vertebroplasty to increase vertebral body height: a cadaveric study. Radiology. Dec 2005;237(3):1115-9. [Medline].
Karlsson MK, Hasserius R, Gerdhem P, et al. Vertebroplasty and kyphoplasty: New treatment strategies for fractures in the osteoporotic spine. Acta Orthop. Oct 2005;76(5):620-7. [Medline].
Trout AT, Kallmes DF, Kaufmann TJ. New fractures after vertebroplasty: adjacent fractures occur significantly sooner. AJNR Am J Neuroradiol. Jan 2006;27(1):217-23. [Medline].
Keywords
lumbar spine fractures and dislocations, lumbar spine trauma, spinal fractures, acute spinal injuries, lumbar vertebral fractures, lumbar compression fracture, thoracolumbar injuries, lumbar injuries, osteoporosis, paraplegia, tetraplegia, spinal cord injury, broken back, chance fracture
