Spinal Dislocations eMedicine Orthopedics

Description: The unique anatomy of the thoracolumbar junction predisposes this level of the spinal column to dislocation fractures. As the thoracic spine loses its structural rigidity with floating ribs at T11 and T12, the orientation of the facet joints also changes from a more frontal projection to oblique and then sagittal in the upper lumbar spine. These spinal dislocation fractures result from violent traumatic injuries and are associated with a very high incidence of neurologic deficit resulting from the translation of the spine. Approximately 90% of dislocations above T10 result in complete paraplegia, and 60% of dislocations below T10 result in complete neurologic deficit. The spinal cord ends at the L1-2 level in most adults; the cauda equina represents the terminal nerve roots of the lumbosacral spine present below this site. The prognosis for a pure nerve root injury is much better than for an actual spinal cord injury. In some of these injuries, spinal cord injury and nerve root damage are combined.
Synonyms and related keywords: facet fracture, dislocation fractures of thoracolumbar spine, back injury, back pain, broken back, thoracic spine fracture
Jacob Goodrich MD 2003