Lumbar burst fracture

Background

Unstable
Can occur with or without injury to posterior elements (posterior involvement increases risk for neuro deficits)
Can be confused with a wedge fracture (especially on plain films)

Vertebral fractures and dislocations types

Vertebral anatomy.

Clinical Features

Mechanism: axial load with failure of the anterior and middle columns

Differential Diagnosis

Thoracic Trauma

Airway/Pulmonary
Cardiac/Vascular
- Cardiac injury
  - Blunt cardiac injury
    - Cardiac contusion
    - Commotio cordis
  - Penetrating cardiac injury
  - Cardiac tamponade
- Traumatic aortic transection
Musculoskeletal
Other

Lower Back Pain

Spine related
- Acute ligamentous injury
- Acute muscle strain
- Disk herniation (Sciatica)
- Degenerative joint disease
- Spondylolithesis
- Epidural compression syndromes
- Thoracic and lumbar fractures and dislocations
- Cancer metastasis
- Spinal stenosis
- Transverse myelitis
- Vertebral osteomyelitis
- Ankylosing spondylitis
- Spondylolisthesis
- Discitis
Renal disease
Intra-abdominal
- Abdominal aortic aneurysm
- Ulcer perforation
- Retrocecal appendicitis
- Large bowel obstruction
- Pancreatitis
Pelvic disease
- PID
Other
- Retroperitoneal hemorrhage/mass
- Meningitis

Evaluation

Obtain CT if unsure (vs. wedge)

See Also

Thoracic and lumbar spine trauma
Vertebral burst fractures

References

This article is issued from Wikem. The text is licensed under Creative Commons - Attribution - Sharealike. Additional terms may apply for the media files.