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Burst Fracture

   

Burst Fracture

synonyms:

Burst Fracture ICD-9

Burst Fracture Etiology / Epidemiology / Natural History

  • Gererally axial load with failure of the vertebral body and bony retropulsion into the spinal canal.

Burst Fracture Anatomy

Burst Fracture Clinical Evaluation

  • Palpate entire spine for tenderness / step off.
  • Complete neuro exam: motor strength, pin-prick sensation, reflexes, cranial nerves, rectal examination (perineal pin-prick sensation, sphincter tone, volitional spincter control)
  • Absence of the bulbocaverosus reflex indicates spinal shock. Level of spinal injury can not be determined until bulbocaverosus reflex has returned.
  • See ASIA form.

Burst Fracture Xray / Diagnositc Tests

Burst Fracture Classification / Treatment

  • Cervical, Stable, neurologically intact: orthosis ro halo vest with or without short period traction / reduction.
  • Cervical, Unstable, neuro deficit: anterior corpectomy, structural grafting and rigid plate fication. Consider supplemental posterior fixation.
  • Thoracolumbar TLICSS <3: short period bedrest followed by mobilization in TLSO ro Risser-like body cast with spine in hyperextension for 10-12 weeks. (Wood K, JBJS 2003;85A:773).
  • Thoracolumbar TLICSS <3: anterior decompression, grafting and instrumentation (Kaneda K, JBJS 1997;79A:69).

Burst Fracture Associated Injuries / Differential Diagnosis

Burst Fracture Complications

Burst Fracture Follow-up Care

Burst Fracture Review References

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