To discuss and review thoracolumbar fractures focusing on: stability; imaging modalities; morphology patterns; treatment.

Spinal injuries constitute a significant proportion of musculoskeletal injuries across the world1,2. The thoracolumbar spine represents the most common area fractured in the spine3. Spine stability is defined as the ability to prevent the development of neurologic injury and progressive deformity in response to physiologic loading and a normal range of movement4. From a spinal surgeon’s point of view, most descriptions used are based on the Denis model5 (Fig.1). Instability varies over time depending on the nature of the structures involved. Bone instability can be...

MORPHOLOGICAL PATTERNS It is well recognized that, on the basis of a specific trauma mechanism, characteristic findings are observed. In general compressive forces result in wedge or burst fractures, distractive forces in ligametous disruption or dislocation, while rotation-shear forces result in combined bone and ligamentous injuries producing fracture dislocation (Fig. 4). The major types of thoracolumbar spine injury are described according to the mechanism of injury: compression or wedge, burst, flexion-distraction or Chance and fracture dislocation. Anterior Wedge Compression Fractures (Fig.5) The mechanism of injury...

The primary objectives of treating patients with spinal injury consist of the preservation of neurological function and restoration of spinal stability while incurring minimal additional morbidity and cost. If image required CT should be the first modality used. Knowledge of the injury mechanism is helpful when interpreting injury patterns, which naturally presumes an excellent communication between first responders, attending trauma surgeons, and radiologist alike. Unstable injuries, such as the 3-column fractures mentioned above, are most often treated operatively. The only situation that can be treated...

Shivanand G., Deepak R., Krithika R., Atin K., Kamran F., Vijay S. Imaging evaluation of traumatic thoracolumbar spine injuries: Radiological review. World J Radiol 2015 Sept. 28; 7(9): 253-265. Frank V.B., Mika P.K., Seppo K.K. Multidetector Computed Tomography of Spinal Fractures. Semin Roentgenol.2012 Oct;47(4):330-41. Wang H, Zhang Y, Xiang Q, Wang X, Li C, Xiong H, et al. Epidemiology of traumatic spinal fractures: Experience from medical university-affiliated hospitals in Chongqing, China, 2001-2010. J Neurosurg Spine. 2012;17:459–68. Looby S, Flanders A. Spine trauma. Radiol Clin North...

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