Three column thoracic spine fracture

Case contributed by Dr Henry Knipe

Presentation

Fall from height.

Patient Data

Age: 30 years
Gender: Female
Modality: X-ray

Abnormal paraspinal opacity at the level of T4-T5. 

Lungs and pleural spaces are clear. Cardiac silhouette is not enlarged. 

Modality: CT

T5 wedge compression fracture with bulging of the posterior cortex. Fracture extends through the pars interarticularis bilaterally as well as the lamina. Thoracic kyphosis with separate of the posterior element fractures. 

Further fractures through the T4 vertebral body and T3 spinous process. Rib / transverse processes are also evident. 

Case Discussion

This is an unstable injury with all three columns involved. The patient had some upper and lower limb weakness, and MRI was performed that demonstrated epidural haematoma causing mild spinal cord compression but no spinal cord injury. 

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Case Information

rID: 46191
Case created: 26th Jun 2016
Last edited: 20th Apr 2017
Inclusion in quiz mode: Included

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