Thoracic/Lumbar Fractures

Question 1

What is the most common fracture of the thoracic/lumbar region?

Answer 1

Compression

Question 2

What mechanism of injury is associated with compression fractures of the lumbar and thoracic spine?

Answer 2

Flexion

Question 3

What is the 2nd most common fracture of lumbar region?

Answer 3

Transverse process

Question 4

Is the anterior or posterior body height affected by compression fractures?

Answer 4

Anterior (posterior portion maintained)

Question 5

For how long are the zone of impaction and step defect usually visible following compression fractures?

Answer 5

2 months (acute phase)

Question 6

What is another name for the zone of impaction?

Answer 6

Zone of condensation

Question 7

What condition represents avascular necrosis/progressive collapse of the vertebra following a compression fracture?

Answer 7

Kummel’s disease

Question 8

What are the four things that can be a SOL?

Answer 8

1 blood 2 pus 3 edema 4 tumor

Question 9

What is usually the cause of a paraspinal line deflection seen on the AP view?

Answer 9

SOL

Question 10

What change in the pedicle region can be seen with a compression fracture on the AP view?

Answer 10

Intrapedicular widening

Question 11

Osteoporotic compression fractures are more common after what age and in what gender?

Answer 11

50, females

Question 12

What is the most common location for osteoporotic compression fractures?

Answer 12

Mid thoracic and thoracolumbar spine

Question 13

What is the term for the increased kyphosis seen with osteoporosis following compression fractures?

Answer 13

Dowager’s hump

Question 14

What is the cause of the change in appearance of the vertebral bodies after osteoporosis on imaging?

Answer 14

Decreased horizontal trabeculae

Question 15

What is different between a pathological and regular compression fracture?

Answer 15

Pathological ones have decrease height of the ENTIRE vertebral body

Question 16

What procedures can be done for osteoporotic compression fractures?

Answer 16

Vertebroplasty, kyphoplasty (cement mixture insert)

Question 17

Can we adjust patients following kyphoplasty?

Answer 17

Yes; be aware of it on imaging

Question 18

Burst fractures do not occur in what region of the spine and why?

Answer 18

Thoracic region (rib protection, decreased movement)

Question 19

What is the major X-ray finding for burst fractures of the lumbar spine?

Answer 19

Posterior body convexity

Question 20

Why are burst fractures in the lumbar spine so serious?

Answer 20

50% cause cord injury

Question 21

How can a burst fracture cause cord issues?

Answer 21

Posterior wall blows out into canal

Question 22

Why do chance fractures occur less today?

Answer 22

Seatbelts now have shoulder strap

Question 23

What kind of mechanism of injury is associated with chance fractures?

Answer 23

Flexion distraction

Question 24

What is a chance fracture?

Answer 24

Horizontal splitting of the arch and body

Question 25

What is the most common location of a chance fracture?

Answer 25

L1-L3

Question 26

What is another name for a chance fracture?

Answer 26

Lap belt fracture

Question 27

What X-ray sign is associated with chance fractures?

Answer 27

Empty vertebra sign

Question 28

Chance fractures are commonly associated with what other fracture?

Answer 28

Compression

Question 29

What causes transverse process fractures?

Answer 29

Direct trauma or avulsion

Question 30

What are the most common areas for transverse process fractures in the lumbars?

Answer 30

L2 and L3

Question 31

What is unique about the distribution of transverse process fractures?

Answer 31

Usually unilateral and multi-level

Question 32

Why are transverse process fractures usually hard to see on X-ray?

Answer 32

Obscured by gas and fecal material

Question 33

Damage to what organ is associated with transverse process fractures?

Answer 33

Kidneys (possible renal failure to do laceration)

Question 34

What sign could be associated with transverse process fractures?

Answer 34

Hematuria

Question 35

How can we tell a burst fracture from a compression fracture?

Answer 35

Posterior wall blow out showing posterior margin convexity