Presentation
Fall from height.
Patient Data
Age: 65 years
Gender: Male
From the case:
Unstable L1 burst fracture
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Frontal
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).
From the case:
Unstable L1 burst fracture
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Axial bone window
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.
From the case:
Unstable L1 burst fracture
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.