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Burst Fracture S32.001A

   

Burst Fracture

synonyms:

Burst Fracture ICD-10

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

    • Cervical: A/P, Lateral, Odontoid:
    • CT cervical spine:
    • MRI:

    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

    • Spinal Cord Injury

    Burst Fracture Complications

    Burst Fracture Follow-up Care

    Burst Fracture Review References