The Orthobullets Podcast Foundations | Spine | Thoracolumbar Burst Fractures
Aug 31, 2025
Dive into the world of thoracolumbar burst fractures! Discover the causes and consequences of these injuries, particularly from high-energy trauma. Learn about the vital role of radiographic imaging in diagnosis and the importance of assessing spinal cord involvement. Explore clinical assessment methods, treatment options, and strategies to preserve neurological function. Case-based questions pepper the discussion, enhancing your grasp on effective management techniques. Get ready to bolster your foundational knowledge!
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Mechanism And Imaging Overview
- Thoracolumbar burst fractures result from axial load with flexion causing anterior and middle column compression and retropulsion into the canal.
- CT helps characterize the fracture and plan surgery while radiographs make the initial diagnosis.
Safe Initial Spine Assessment
- Log-roll trauma patients to avoid iatrogenic spinal cord injury and inspect for skin wounds and spinous process tenderness.
- Evaluate motor, sensory, reflexes, and look for signs of spinal shock like absent bulbocavernosus reflex.
Limits Of Plain Films
- Flexion/extension lateral radiographs help assess posterior ligamentous complex integrity after stabilization.
- Plain radiographs can underestimate canal retropulsion, so CT is often needed for full evaluation.