Spine Injuries

In patients with less than 30° of kyphosis and less than 50% loss of vertebral body height, the injury can be treated non-operatively with the use of a thoracolumbar orthosis. Patients can then be mobilized in this brace, which should be used for at least 3 months. Lateral flexion and extension films should then be obtained with the patient out of the brace. In the absence of excessive motion and no progression of the angular deformity, the patient can then be weaned off the orthotic device and physical therapy instituted, to strengthen the atrophied musculature. Progression of the deformity and/or incapacitating pain are indications for surgical stabilization.

Burst Fractures

This type comprises 15-20% of all major vertebral body fractures in most series. It results from failure of the vertebral body under an axial load, with associated flexion. The anterior and middle columns are affected, making it an unstable type of injury. Radiographic features include comminution of the vertebral body, increase of the interpediculate distance, vertical fracture of the laminae, loss of posterior vertebral body height and retropulsion of bone fragment into the canal can be appreciated. This injury has been sub-divided into five different subgroups, according to Denis (Fig. 22.8) [28].

Fig. 22.8. Illustration of the common fracture patterns seen with burst fractures. Burst fractures have been sub-divided into five different subgroups according to Denis. The type A fracture is characterized by fractures of both the superior and inferior end plates, usually as a result of an axial load. The types B and C burst fractures involve the superior and inferior end plates, respectively. These result from an axial load coupled with a flexion load. An axial and a rotational load give rise to a type D burst fracture. The type E fracture is characterized by widened pedicles with a burst and lateral flexion injury.

Fig. 22.8. Illustration of the common fracture patterns seen with burst fractures. Burst fractures have been sub-divided into five different subgroups according to Denis. The type A fracture is characterized by fractures of both the superior and inferior end plates, usually as a result of an axial load. The types B and C burst fractures involve the superior and inferior end plates, respectively. These result from an axial load coupled with a flexion load. An axial and a rotational load give rise to a type D burst fracture. The type E fracture is characterized by widened pedicles with a burst and lateral flexion injury.

Cure Your Yeast Infection For Good

Cure Your Yeast Infection For Good

The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.

Get My Free Ebook


Post a comment