OWL: OCOSH Classification/Trauma/Back and Spinal Injuries/Spinal Injuries/Spinal Fractures/Lumbar Fractures

Chance Fracture eMedicine Orthopedics

Goodrich — 2008-03-26 22:33:33 GMT

Patients complaining of back pain following motor vehicle accidents or falls from significant heights should be considered to have spinal injuries until proven otherwise. With flexion-distraction mechanisms such as those observed in passengers restrained with lap seatbelts, a progression of injury from the posterior column of the thoracolumbar spine is observed anteriorly. When this involves only the osseous structures, a Chance injury exists. The diagnosis is best made on good quality radiographs obtained in 2 planes (anteroposterior [AP] and lateral). Prompt recognition followed by appropriate reduction and immobilization usually results in a good clinical outcome. Always exclude associated injuries (eg, intra-abdominal trauma) at the time of presentation, as these are observed in up to 50% of cases, particularly in children.
Synonyms and related keywords: flexion-distraction injury, thoracolumbar spine injury Author: Jacob Goodrich, MD 2005

Compression Fractures Wheeless

C.R.Wheeless — 2008-08-14 22:33:33 GMT

Notes on differential diagnosis, x-ray and investigation, classification and treatment

Fracture of the Lumbar Spine & Pelvis

Not Available — 2008-08-28 22:33:33 GMT

Epidemiological study in England

Fracture of the Thoracic and Lumbar Spine Patient Information AAOS

Not Available — 2008-01-28 22:33:33 GMT

Fracture of one or more bones of the spinal column (vertebrae) of the middle (thoracic) or lower (lumbar) back is a serious injury. It is usually caused by high-energy trauma such as a car crash, fall, sports accident, or violent act (for example, a gunshot wound). People with osteoporosis, tumors, or other underlying conditions that weaken bone can get a spinal fracture with minimal trauma or normal activities of daily living.
Contents - Symptoms Diagnosis Classification of Spine Fractures Treatment

Fractures of L4 and L5

Peter A Robertson, MD FRACS — 2008-08-28 22:33:33 GMT

Lower lumbar fractures.
Fractures of L4 and L5 differ from those at the thoracolumbar junction. The differences involve anatomy, biomechanics, treatment options and classification. The rarity of these injuries is evident from their limited discussion in the literature. Treatment must be individualised and the recommendations for thoracolumbar trauma management cannot necessarily been transferred to low lumbar fractures.
Peter A Robertson, MD FRACS

How we treat recent thoracic and lumbar spine fractures

Louis et al — 2008-08-28 22:33:33 GMT

About 10,000 thoracic and lumbar spine fractures are treated every year in France. In our experience, a few very minor cases can be treated with bed rest and physiotherapy; 60 % of lesions can be managed with closed treatment; and only 30 % will require surgery. Our experience includes more than 500 cases treated in our Department over a 25-year period.
C. LOUIS, S. NAZARIAN, R. LOUIS H�pital de la Conception, Marseille

Lumbar Burst Fractures Wheeless

C.R.Wheeless — 2008-08-14 22:33:33 GMT

- typical injury pattern for burst fractures varies w/ anatomic level;
- L1 to L3 pedicles are frequently comminuted or detached;
- L4 to L5 fractures usually present a consistent pattern:
- L4 & L5 pedicles are stout & usually remain intact;
- pedicles are usually not fractured & remain attached to caudal halves the vertebral body;
- kyphosis is usually not present;
- cephalad third of vertebral body is fractured w/ central retropulsion of bone into canal;
- significant stenosis may be present;
- displaced laminar fractures may entrap dura and cauda equina;

Lumbar Compression Fracture eMedicine PMR

Sherman & Razack — 2008-08-10 22:33:33 GMT

The lumbar vertebrae are the 5 largest and strongest of all vertebrae in the spine. These vertebrae compose the lower back. They begin at the start of the lumbar curve (ie, the thoracolumbar junction) and extend to the sacrum. The strongest stabilizing muscles of the spine attach to the lumbar vertebrae. End-stage osteoporosis often culminates with bony fractures. Fractures occur most commonly in the hips, wrists, arms, and spine. Osteoporotic spine fractures are unique because they may occur without apparent trauma. A thorough diagnostic workup is always required to rule out malignancy.
Synonyms and related keywords: lumbar crush fracture, osteoporotic fracture, collapse fracture, osteoporosis, vertebra fracture, vertebral fracture, burst fracture, wedge fracture, spinal wedge fracture, vertebroplasty, kyphoplasty
Sherman & Razack 2007

Lumbar Compression Fracture Gentili

Gentili — 2008-08-28 22:33:33 GMT

Radiology of compression fractures

Lumbar Spine Fractures and Dislocations eMedicine Orthopedics

Federico C Vinas, MD — 2008-08-10 22:33:33 GMT

Each year, more than 150,000 persons in North America sustain fractures of the vertebral column. Injuries to the thoracolumbar and lumbar spine constitute most of these fractures. The immediate neurologic damage that accompanies the bony destruction results in nearly 5000 cases of paraplegia per year. The mechanisms and severity of injuries reflect a mechanized and risk-taking culture. This article reviews the diagnosis and management of acute lumbar vertebral fractures.
Synonyms and related keywords: spinal fractures, acute spinal injuries, lumbar vertebral fractures, thoracolumbar injuries, lumbar injuries, paraplegia, tetraplegia, spinal cord injury, broken back
Federico C Vinas, MD 2007

Lumbar Spine Trauma eMedicine Radiology

Nadalo, Van Meter & Moody — 2008-08-10 22:33:33 GMT

Fracture of the lumbar spine can occur whenever forces applied to the lower spinal column exceed the strength and stability of the spinal column unit. Common injuries resulting in fractures of the lumbar spine include fall from a height; motor vehicle and motor vehicle and pedestrian accidents; and penetrating trauma, including gunshot wounds and stabbings. Unstable injuries to the pelvis often are associated with injury to the sacral plexus and the lower lumbar spine.
The goal of the diagnostic radiologist is to identify lumbar spine fractures correctly, to identify and correlate neurologic injury to vertebral fractures, to advise the surgeon (who best defines the extent of injury to supporting structures), to gauge the risk to the spinal cord, and to judge the stability of postoperative fixation. This article highlights the typical patterns of injury and focuses on the imaging methods that are most useful in the clinical practice of trauma radiology.
Synonyms and related keywords: Chance fracture, pathologic fracture, burst fracture, insufficiency fracture, spondylolysis deformity, spondylolisthesis, lumbar spine trauma, lumbar spine injury, lumbar spine fracture
Nadalo, Van Meter & Moody 2007

Lumbosacral Spine Acute Bony Injuries eMedicine Sports

Federico C Vinas, MD — 2008-08-10 22:33:33 GMT

Spinal fractures are relatively uncommon in sports participation compared with other types of injuries; most injuries to the lumbar spine are relatively minor and fit into the category of soft-tissue injuries. These soft-tissue injuries are usually self-limited and resolve without coming to the attention of healthcare professionals. The mechanisms and severity of sports-related lumbar spinal injuries reflect a competitive and risk-taking culture.1, 2, 3, 4, 5, 6 Lumbar spine bony injuries are often limited to specific sports, most frequently seen in sports such as automobile or motorcycle racing, skydiving, power weight lifting, wrestling, gymnastics, football, horseback riding, and high-speed snow sports. This article reviews the diagnosis and management of acute lumbar vertebral fractures.
Synonyms and related keywords: lumbosacral spine acute bony injuries, lumbosacral fractures, sports-related spine fractures, spine fracture, broken back, lumbar spine injury, low back pain, LBP, back injuries, spine injuries, spinal injuries, paraplegia, quadriplegia, acute lumbar spine fracture, lumbar spine fracture, lumbosacral spine fracture, spinal cord injury
Federico C Vinas, MD 2008

Multi-Level Transverse Process Fractures PFATS

Hunkele et al — 2008-08-14 22:33:33 GMT

Multi-Level Transverse Process Fractures In A Professional Football Player: A Case Study Tom Hunkele, MPT, ATC, Eric Sugarman, MS, ATC, Robert Roche MS, ATC, David Fischer, MD, Gary Fetzer, MD
Professionla Football Athletic Trainers Society PFATS This case study follows a 6�3�, 215-lb wide receiver in his 10th year in the NFL. He suffered his initial injury during the third quarter of a regular season game when the player jumped to catch a ball and was struck in his low back while being tackled.

Nonoperative Treatment of Osteoporotic Compression Fractures eMedicine PMR

Cooper Lin & Lane — 2008-08-10 22:33:33 GMT

Vertebral compression fracture is the most common complication of osteoporosis. More than 700,000 new vertebral compression fractures occur every year in the United States alone, accounting for more than 100,000 hospital admissions and resulting in close to $1.5 billion in annual costs.
Synonyms and related keywords: osteoporosis, back pain, osteoporotic vertebral compression fractures, diminished bone density, vertebroplasty, kyphoplasty, wedge-shaped compression fractures, acquired kyphosis, general height loss, central crush fracture, bone density loss
Authors Cooper Lin & Lane 2008

Posterior pedicle screw fixation for thoracolumbar burst fractures

Leduc et al — 2008-02-05 22:33:33 GMT

Posterior pedicle screw fixation with supplemental laminar hook fixation for the treatment of thoracolumbar burst fractures S. Leduc, J-M Mac-Thiong, G. Maurais, A. Jodoin Can J Surg, Vol. 51, No. 1, February 2008
This study evaluates the clinical relevance of the short-segment pedicle fixation supplemented by laminar hooks (2HS-1SH) construct in the surgical treatment of thoracolumbar burst fractures. The 2HS-1SH construct provides significant correction of vertebral body height and local kyphosis. It also preserves the initial correction and minimizes the risk of instrumentation failure.