Masezza.com – Patients with a thoracic burst fracture were reviewed in a recent study. Results were based on CT and magnetic resonance imaging. They were also evaluated for neurologic status and treatment options. One patient experienced two separate fractures in the same region. The researchers concluded that the diagnosis of thoracic burst fracture is not as common as previously believed. The primary reason for this is that it is difficult to diagnose and can lead to complications.
In many cases, these fractures require surgery
A burst fracture occurs when the anterior or middle columns of a vertebral body collapse. The bone fragments then retropel backwards through the spinal canal, compressing the spinal cord and nerve roots. In many cases, this fracture requires surgery to stabilize the spine and remove any bone material that may touch the spinal cord or nerve roots. This type of procedure is associated with a high risk of neurological complications.
One such case described a 36-year-old male with a thoracic burst fracture of the L2 vertebra. The x-ray showed a 55% compression ratio. A kyphotic angle was calculated, which measures the angle between the superior end plate of the vertebrae above the fractured level and the inferior end plate. The resulting angle was a compression ratio of 55%.
The study included all patients with a thoracolumbar burst fracture diagnosed between January 2006 and February 2019. In addition, the researchers identified patients with a three-column injury and a decrease in anterior body height of 40% or more. In addition, the researchers also measured the morphology, neurologic involvement, and posterior ligamentous complex integrity of patients with a thoracolumbar burst fracture and compared it to a TLICS score.
The study was not blind to treatment
While these results are promising, they are not conclusive. However, the study was not blinded to treatment. Patients had no idea which treatment they were receiving, and neither side reported improved clinical outcomes. The study also was limited by the fact that it only included a small number of patients and was not powered to evaluate outcomes in a standardized fashion. There is no definitive evidence for the effectiveness of a thoracic brace, but researchers found that it is more effective than other treatment options in certain cases.
There are two main options for nonoperative management of thoracic burst fractures. One option is external bracing, which is widely used in some countries. However, nonsurgical treatment without a brace has been demonstrated to be safe. Nonoperative bracing can help optimize resource utilization and increase patient engagement. The goal of this guideline is to provide more information and options for treating this thoracolumbar trauma.
The posterior abdominal wall is frequently involved and exerts upward pressure on the mesosternum
The most common cause of thoracic burst fracture is a fall. When the thoracic spine is forced downward, the hip strikes the ground first. This imposes a tremendous amount of violence on the lower spine. Because of this, the lower back buckles. In addition, the posterior abdominal wall is often involved and exerts upward pressure on the mesosternum. A combination of these forces is required to create a thoracolumbar fracture.
In this case, a 36-year-old male presented with a thoracic burst fracture of the L1 vertebra. Neurologic signs included conus-cauda equina compression, urinary retention, and patchy sensory loss. His patient underwent MRI of the spine, which showed a 70% loss of vertebral body height and eight-mm posterior bony retropulsion into the spinal canal. The cord showed a T2-weighted hyperintensity consistent with edema.
Patients with thoracic burst fracture are at risk for a number of serious complications. If an associated injury occurs, treatment options may include a thoracic compression device, a ventilator, and a sternum fracture. This is a relatively uncommon cause of thoracic fracture, although it is a potentially life-threatening condition. In the majority of cases, treatment involves bedside care.
Thoracic vertebral burst fractures are not a rare condition
Children’s motorbike use is becoming increasingly widespread, and children’s motorbike accidents may be the cause of thoracic spine fractures. The case described here was part of a cohort of six patients with thoracic fractures. The other four patients were treated with cast/bracing without surgery. Thoracic vertebral burst fracture is not a rare condition, but proper diagnosis and treatment may help prevent further complications.
In addition to treating a thoracic burst fracture, patients should consider the severity of their spinal deformity. In a study of patients with this condition, the kyphotic deformity was corrected in all but one patient. In contrast, the patient with a sternum fracture suffered a lesser degree of spinal deformity, while the other patient suffered only a sternum fracture.
