Transcript Thoracic Spine Trauma - Logan Class of December 2011

Thoracic Spine
Trauma
Presented by M.A. Kaeser, DC
Spring 2009
Compression Fractures
 M/C between T11 and T12
 Combination of axial and flexion injury
 Compression fractures between the T4 and T8
segments occasionally occur in association
with injuries related to convulsive seizures or
electric shock therapy as a result of violent
contractions of the thoracic and abdominal
muscles
 Most are wedge shaped w/few having any
neurological deficits
Paraspinal edema
 May be an indirect clue to the presence
of a fracture
http://download.imaging.consult.com/ic/images/S1933033207730938/
gr3-midi.jpg
Pathologic fractures
 Loss of posterior body height, pedicle
and other structures and a paraspinal
mass
MRI findings
 Abnormal marrow can be demonstrated
 Used to assess the involvement of the
spinal cord
Fracture-Dislocation
 Occurs most often in the T4-T7 region
 Fractures of the lamina, facets or
vertebral bodies are often associated
with neurological damage or paralysis
because the spinal canal is small and the
blood supply is relatively sparse
 Unstable thoracic injuries may benefit
from surgical stabilization
http://www.ajronline.org/cgi/content-nw/full/187/4/859/FIG12
MOI
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Severe MVAs
Motorcycle
accidents – rider
is catapulted into
stationary objects
http://www.seeitornot.faketrix.com/content/thrash-pics/originals/bike-crashmotorcycle-accident-rider-loses-control.jpg
Radiographic Depiction
 Difficult and requires an overpenetrated frontal
view
 Loss of vertebral body height
 Displacement
 Widened interpediculate distance
 Paraspinal widening
 Associated injuries: other fractures, aortic arch
tears, sternal fractures, thoracic disc
herniation, instability and rarely, Kummel’s
disease
References
Yokum TR, Rowe LJ. Essentials of Skeletal
Radiology. Baltimore: Williams &
Wilkins, 1996: 373–545.