|
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
Burst Fracture Complications
Burst Fracture Follow-up Care
Burst Fracture Review References
|