Presentation
Fall from height.
Patient Data




The L1 vertebra is wedge-shaped with the anterior outline appearing ill-defined, suggesting acute compression. Retropulsion can also be observed. The involvement of the spinous process is more subtle, yet clearly visible as a broad lucency (see annotated image).













A comminuted burst fracture is visible, which involves all three columns. The retropulsion is compressing the spinal cord while a traumatic left foraminal stenosis can also be discerned.

Key image showing that spinous process involvement can be detected on the x-ray.
Case Discussion
This L1 burst fracture is unstable as all three columns are involved.