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Thoracic Spine Trauma

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

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  1. Thoracic Spine Trauma Presented by M.A. Kaeser, DC Spring 2009

  2. 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

  3. Paraspinal edema • May be an indirect clue to the presence of a fracture http://download.imaging.consult.com/ic/images/S1933033207730938/ gr3-midi.jpg

  4. 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

  5. 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

  6. 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

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

  8. 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

  9. 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

  10. References Yokum TR, Rowe LJ. Essentials of Skeletal Radiology. Baltimore: Williams & Wilkins, 1996: 373–545.

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