1. Lumbar Spinal Fractures
By: Amadeo Beraun

2. Pathomechanics-Denis’ 3 columns
Anterior
Middle
Posterior
Spinal instability
“The loss of the ability of the spine under physiological loads to maintain relationships between vertebra in such a way that there is neither damage or subsequent irritation to the spinal cord or it’s nerve roots, and in addition there is no development of incapacitating deformity or pain.”-White and Panjabi.

3. What specific forces acting on the lumbar spine produce fractures?
Compressive force
Rotational force
Tensile force
Shear force

4. Compressive/Tensile force

5. Rotational/Shear force

6. Explanation-Why are lumbar spinal fractures common?
5 lumbar vertebrae are the strongest of the spine.
As we age we all lose bone mass, therefore bone density.
Most people aren’t aware of the awkward direction of forces they place on the lumbar region.
We don’t utilize good form when lifting from the ground.
People seem to care more about the look of their arms and abs instead of their back muscles.

7. Who is more susceptible to fractures of the lumbar spine?
Age—decrease in bone density
Weight—curvatures of spine
Gender—females after menopause (high risk)-
Nutrition—need calcium, vitamin d, and vitamin k
Fitness—apply loads to build stronger bones
Congenital—genetics

8. Age
Elderly
Young adult

9. Weight
Lean
Obese

10. Gender
Male
Female

11. Nutrition
Good
Bad

12. Fitness
Sedentary
Active

13. Congenital

14. Where on the lumbar spine region do fractures most commonly occur?
Thoracolumbar region
Flexion/Rotation (fracture-dislocation)

15. T-11 through L-1

16. Flexion/Rotation
Lumbar
Thoracic

17. Justification Recovery Prevention Back brace Massage Physical therapy
Medication
Nutrition
Calcium-Restore
Vitamin D-Absorption
Vitamin K-Transport
Exercise-load bearing
Posture
Good form when lifting
Controlled movements (not fast jerking motions)

18. What can be done to prevent the occurrence of lumbar spine fractures?
Posture
Tissue stiffness

19. Posture
Good
Bad

20. Tissue Stiffness
Anterior
Posterior

21. How are fractures of the lumbar spine treated?
Assessment
CT scan
Brace

22. Assessment

23. CT Scan

24. Brace
External
Internal

25. What is the rehabilitation process for fractures of the lumbar spine?
Conservative management
Operative management

26. Conservative Management

27. Operative Management

28. Description-Lumbar spine fractures
Compression fracture-anterior segment
Chance fracture-horizontal plane
Burst fracture-anterior and middle segments
Organs-poly trauma
Flexion/distraction (fracture-dislocation)-middle and posterior segments
Vehicle accident-seat belts

29. Personal Reaction-Lumbar fractures
Realize compression fractures are most common.
Most fractures occur in thoracolumbar region. (function change)
Exercising the stabilizer muscles is very important.
Understand the importance of good form for lifting and posture.
The lumbar spine consists of our strongest vertebrae, but we shouldn’t take that as a challenge to test it.
Be aware of bone density decreasing with age.

30. Videos

31. References
Gardner, A., S. Grannum, and K. Porter. "Thoracic and Lumbar Spine Fractures." Trauma 7.2 (2005): Academic Search Premier. Web. 26 Apr
Waterloo, Svanhild, et al. "Prevalence of Vertebral Fractures in Women and Men in the Population-Based Tromsø Study." BMC Musculoskeletal Disorders 13.1 (2012): 1-9. Academic Search Premier. Web. 26 Apr
Scannell, Joan P, and Stuart M McGill. "Lumbar Posture--Should It, and Can It, Be Modified? A Study of Passive Tissue Stiffness and Lumbar Position during Activities of Daily Living." Physical Therapy (2003): Academic Search Premier. Web. 26 Apr
Bakhtiary, Amir Hoshang, Ziaeddin Safavi-Farokhi, and Asghar Rezasoltani. "Lumbar Stabilizing Exercises Improve Activities Of Daily Living In Patients With Lumbar Disc Herniation." Journal of Back & Musculoskeletal Rehabilitation 18.3/4 (2005): Academic Search Premier. Web. 26 Apr