Thoracolumbar Spine Fracture


The thoracic spine (to approximately T11) is more rigid than the cervical and lumbar spine due to its articulation with the rib cage but its canal is narrow. Injury to the thoracic spine is therefore less common, but is often associated with spinal cord injury.

Injuries

Bony Considerations

Spinal Cord and Canal

Vascular Supply

Final Points

Acute Treatment

  1. Trauma ABCs
  2. Immobilization
  3. If intubation required
  4. Continue with primary survey
  5. For spinal cord injury:
  6. Other issues
  7. Reduction of fracture (Neurosurg / ortho)

Disposition

  1. Admit
  2. Surgical intervention (reduction/ decompression/ fusion)
      • Incomplete injury with worsening neuro exam
      • Incomplete deficits with an irreducible fracture
      • Severely unstable fracture with complete deficit
        • Allows earlier mobility

 

Other TL-Spine Fractures