Burst fracture with cauda equina syndrome

Case contributed by Ian Bickle
Diagnosis certain


Young male worker falling from 20ft. Back pain and lower limb sensory deficit.

Patient Data

Age: 30 years
Gender: Male

Severe L2 vertebral body fracture with signfiicant retropulsion, with resultant narrowing of the central canal. Bilateral transverse L2 process fractures.

Additional small posterior corner fracture of the L3 vertebral body.

Acute L2 vertebral body fracture, with significant retropulsion, severely narrowing the central canal (absolute stenosis) and impinging on the conus/origin of the cauda equina.

Small superior posterior L3 vertebral body fracture.

Case Discussion

Burst fractures typically occur due to a fall from a significant height, with compressive axial forces resulting in the vertebral body 'bursting', commonly with retropulsion of the fracture.  Burst fractures usually occur in the thoracolumbar junction vertebral bodies.

One cannot underestimate the necessity for rigorous health and safety standards, along with strong enforcement in protecting workers against unnecessary injuries in advanced societies.  

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