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 primary survey with ABC assessment with C-spine immobilization and hemorrhage control.

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

If the decision to operate is made, this should occur earlier rather than later.

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 disk prolapse, ligamentous injury, and epidural hematoma causing pressure on the spinal cord or nerve roots; these occur very rarely without a fracture. This topic focuses on thoracolumbar spine fracture.