Thoracic spine trauma
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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

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Thoracic spine trauma

Thoracic Spine Trauma

Presented by M.A. Kaeser, DC

Spring 2009


Compression fractures

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

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

Pathologic fractures

  • Loss of posterior body height, pedicle and other structures and a paraspinal mass

http://www.medscape.com/content/2003/00/46/53/465374/art-nf465374.fig3.jpg


Mri findings

MRI findings

  • Abnormal marrow can be demonstrated

  • Used to assess the involvement of the spinal cord

http://www.biij.org/2007/4/e10/fig4.jpg


Fracture dislocation

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


Thoracic spine trauma

http://www.ajronline.org/cgi/content-nw/full/187/4/859/FIG12


Thoracic spine trauma

MOI

  • Severe MVAs

  • Motorcycle

  • accidents – rider

  • is catapulted into

  • stationary objects

http://www.seeitornot.faketrix.com/content/thrash-pics/originals/bike-crash-

motorcycle-accident-rider-loses-control.jpg


Radiographic depiction

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

References

Yokum TR, Rowe LJ. Essentials of Skeletal Radiology. Baltimore: Williams &

Wilkins, 1996: 373–545.


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