![]() It does not usually affect stability.įracture-dislocation. This uncommon fracture results from rotation or extreme sideways (lateral) bending. This type of fracture can occur in a head-on car collision when the upper body is thrown forward while the pelvis is stabilized by a lap seat belt. The vertebra is literally pulled apart (distraction). Extension Fracture Patternįlexion/distraction (Chance) fracture. ![]() Some fractures are stable, while others are significantly unstable (the bones have moved out of place). An axial burst fracture can sometimes result in nerve compression. It is often caused by landing on the feet after falling from a significant height. In this type of fracture, the vertebra loses height on both the front and back sides. Prospective Measurement of Function and Pain in Patients with Non-Neoplastic Compression Fractures Treated with Vertebroplasty.A compression fracture of the lumbar (lower) spine.Īxial burst fracture. Late outcome of nonoperative management of thoracolumbar vertebral wedge fractures. Vertebral fractures without neurological deficit. Īssessment of the risk of vertebral fracture in menopausal women. watch for increasing kyphotic deformity or if pt's pain has not resolved, elective stabilization and arthrodesis should be consideredĪnterolateral compression fracture of the thoracolumbar spine. ref: Quality of Life Following Vertebroplasty. note: a brace should not be considered a substitute for a well molded hyperextension cast even w/ spinal instability - may have good response w/ a hyperextsion cast spinal segment will fail with weight bearing angulation of thoracolumbar junction > 20 deg early ambulation is encouraged in a hyperextension orthosis. depending on degree of compression, pt may be treated effectively by hyperextension exercises & avoidance of compression overloads for period of approximately 12 weeks. avoidance of compression overloads for a period of 12 weeks early ambulation is encouranged in a hyperextion orthosis if bowel sounds and flatus are not present then patient should be made NPO, and should receive IV Fluid in some cases an NG tube is required for severe ileus most pts can be treated symptomatically w/ short period of bed rest until pain is diminished non operative treatment remains the standard for compression fx many of these problems are overcome by frontal & sagittal reformation. minimal vertebral body compression fractures may be missed disadvantage of axial CT is its inability to detect subtle horizontally oriented fractures of the vertebral bodies, pedicles, or lamina visualizes spinal canal, degree of neural compromise, and delineates element involvement, particularly in a burst fracture allows good visualization of the posterior elements, which is necessary inorder to rule out the possibility of Chance fracture amount of anterior compression should be no more than 40 % (relative to posterior vertebral body height (otherwise a burst frx may be present) there is no anterior or posterior translation of the vertebral bodies anterior ht of vertebra body is diminished, while posterior ht remains nl ![]() radiographs: (see radiographs for burst frx) in some cases there may be disruption of posterior column in tension, as upper segments hinge forward on middle column ![]() middle column remains intact & may act as hinge compression frx result from anterior or lateral flexion causing failure of the anterior column Type D - buckling of anterior cortex w/ both end plates intact Type B - involvement of superior end plate Type A - involvement of both end plates 4 types of compression frx according to Denis classification a good quality AP radiograph may help rule out compression frx (absence of posterior element frx) be suspicious of "compression" fractures in young patients involved in MVA these frx are normally stable (assumming the dx is correct) & rarely involve neurologic comprimise determine whether the frx is stable or unstable Back pain and vertebral crush frxs: an unemphasized mode of presentation for primary hyperparathyroidism.
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