Acute L1 burst compression fracture

Case contributed by Dr Henry Knipe

Presentation

Fall from more than 2 metres. Impact onto coccyx. Lumbar pain.

Patient Data

Age: 40
Gender: Male
Modality: X-ray

Compression fracture of L1 is noted with approximately 30% loss of height anteriorly. Mild narrowing of the central canal at this level.

Targeted T12-L2 examination

Modality: CT

Burst compression fracture of the L1 vertebral body is associated with 35% loss of vertebral body height. The fracture line breaches both the anterior and posterior vertebral body cortex and the anterior superior endplate. There is 3 mm retropulsion into the spinal canal, resulting in only mild canal narrowing. Alignment is otherwise intact. No other fracture detected. The paraspinal soft tissues are unremarkable.

Conclusion:

L1 burst fracture representing a two-column injury.

Case Discussion

  • most often the result of axial loading in high-energy trauma (e.g. fall from height, motor vehicle collision)
  • burst fractures are a subtype of compression/crush fractures
  • retropulsion of bone fragments can result in central canal stenosis, nerve root or spinal cord injury, or vascular injury
PlayAdd to Share

Case Information

rID: 34430
Case created: 19th Feb 2015
Last edited: 29th Aug 2015
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.