Thoracolumbar spine trauma

Thoracolumbar spine trauma usually occurs as a result of high-energy trauma (e.g., road traffic accidents, falls from heights).

May occur spontaneously in patients with osteoporotic, neoplastic, or metabolic disorders of the spine.

Initial on-the-scene evaluation involves performing a primary survey with ABC assessment with spinal motion restriction and haemorrhage control.

It is important to evaluate and assess thoracolumbar fractures for instability.

If surgical intervention is indicated, early surgery is recommended.

Thoracolumbar fractures are breakages in the vertebrae of the spinal column in the thoracic and lumbar regions. They may be associated with disruption of the ligamentous complexes, and can result in instability or compression of neural structures. Thoracolumbar fractures are the usual outcome of thoracolumbar trauma. Other outcomes include traumatic disc prolapse, ligamentous injury, and epidural haematoma causing pressure on the spinal cord or nerve roots; these occur very rarely without a fracture. This topic focuses on thoracolumbar spine fracture.