Highlights & Basics
- Thoracolumbar spine trauma usually occurs as a result of high-energy trauma (e.g., road traffic accidents, falls from heights).
- May occur spontaneously in patients with osteoporotic, neoplastic, or metabolic disorders of the spine.
- Initial on-the-scene evaluation involves performing a primary survey with ABC assessment with spinal motion restriction and hemorrhage control.
- It is important to evaluate and assess thoracolumbar fractures for instability.
- If surgical intervention is indicated, early surgery is recommended.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
Modified Maegerl (AO/ASIF) classification of thoracolumbar injuries
Denis definitions of types of spinal fracture
Denis classification of spinal fracture
MRI thoracic spine: sagittal view (T2-weighted sequence) showing a pathologic fracture of the T10 vertebral body caused by multiple myeloma
MRI lumbar spine: sagittal view (T2-weighted sequence) showing an osteoporotic fracture of the T12 vertebral body
ASIA Standard Neurological Classification of Spinal Cord Injury: impairment scale
Spinal cord injury
MRI lumbar spine: axial view (T2-weighted sequence) showing an osteoporotic fracture of the T12 vertebral body
Management of thoracolumbar fractures
Citations
American College of Surgeons. Best practices guidelines. Spine injury. Mar 2022 [internet publication].[Full Text]
National Institute for Health and Care Excellence. Spinal injury: assessment and initial management. Feb 2016 [internet publication].[Full Text]
Fischer PE, Perina DG, Delbridge TR, et al. Spinal motion restriction in the trauma patient - a joint position statement. Prehosp Emerg Care. 2018 Nov-Dec;22(6):659-61.[Abstract][Full Text]
O'Toole JE, Kaiser MG, Anderson PA, et al. Congress of Neurological Surgeons systematic review and evidence-based guidelines on the evaluation and treatment of patients with thoracolumbar spine trauma: executive summary. Neurosurgery. 2019 Jan 1;84(1):2-6.[Abstract][Full Text]
American College of Radiology. ACR appropriateness criteria: suspected spine trauma. 2018 [internet publication].[Full Text]
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