1. Presented by M.A. Kaeser, DC Spring 2009
Thoracic Spine Trauma
Presented by M.A. Kaeser, DC
Spring 2009

2. Compression Fractures
M/C between T11 and T12
Combination of axial and flexion injury
Compression fractures between the T4 and T8 segments occasionally occur in association with injuries related to convulsive seizures or electric shock therapy as a result of violent contractions of the thoracic and abdominal muscles
Most are wedge shaped w/few having any neurological deficits

3. Paraspinal edema May be an indirect clue to the presence of a fracture
gr3-midi.jpg

4. Pathologic fractures
Loss of posterior body height, pedicle and other structures and a paraspinal mass

5. MRI findings Abnormal marrow can be demonstrated
Used to assess the involvement of the spinal cord

6. Fracture-Dislocation
Occurs most often in the T4-T7 region
Fractures of the lamina, facets or vertebral bodies are often associated with neurological damage or paralysis because the spinal canal is small and the blood supply is relatively sparse
Unstable thoracic injuries may benefit from surgical stabilization

8. MOI Severe MVAs Motorcycle accidents – rider is catapulted into
stationary objects
motorcycle-accident-rider-loses-control.jpg

9. Radiographic Depiction
Difficult and requires an overpenetrated frontal view
Loss of vertebral body height
Displacement
Widened interpediculate distance
Paraspinal widening
Associated injuries: other fractures, aortic arch tears, sternal fractures, thoracic disc herniation, instability and rarely, Kummel’s disease

10. References
Yokum TR, Rowe LJ. Essentials of Skeletal Radiology. Baltimore: Williams &
Wilkins, 1996: 373–545.