Diagnosis and Management of Thoracolumbar Spine Fractures by Alexander R. Vaccaro, David H. Kim,...

Diagnosis and Management of Thoracolumbar Spine Fractures

by Alexander R. Vaccaro, David H. Kim, Darrel S. Brodke, Mitchel Harris, Jens Chapman, Thomas Schildhauer, M.L. Chip Routt, and Rick C. Sasso

J Bone Joint Surg AmVolume 85(12):2456-2470

December 1, 2003

©2003 by The Journal of Bone and Joint Surgery, Inc.

The Denis three-column model of spinal injury1.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Lateral radiograph showing the characteristic wedge-shaped appearance of a thoracolumbar compression fracture with mild local kyphosis.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Denis classification of thoracolumbar compression fractures (see text).

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Denis classification of thoracolumbar burst fractures (see text).

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Lateral radiograph showing the typical appearance of a thoracolumbar burst fracture.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Computed tomography scan demonstrating retropulsion of posterior vertebral bone and spinal canal compromise.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Postoperative lateral radiograph showing the posterior instrumentation used in this patient.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Computed tomography scan with sagittal reconstruction showing a thoracolumbar flexion-distraction injury.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Radiographs showing the typical appearance of a thoracolumbar fracture-dislocation.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Magnetic resonance image of a patient with a thoracolumbar injury.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Magnetic resonance image of a patient with a flexion-distraction injury, revealing gas in the posterior subcutaneous tissue overlying the level of the thoracolumbar injury.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Sagittal magnetic resonance image of a patient with a T12 burst fracture and an incomplete neurological injury.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Anteroposterior (Fig. 11-B) and lateral (Fig. 11-C) postoperative radiographs.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Sagittal magnetic resonance image of patient with a complete neurological deficit following a substantial flexion-distraction injury.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.

Following posterior short-segment instrumentation, the fracture was stable and healed uneventfully.

Alexander R. Vaccaro et al. J Bone Joint Surg Am 2003;85:2456-2470

©2003 by The Journal of Bone and Joint Surgery, Inc.