Thoracic Spine Trauma - Logan Class of December 2011
Download
Report
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
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.