Abstract
HS is a 21-year-old male who presents status post fall from 20 ft, transferred via EMS. On presentation, the patient demonstrates a GCS of 15, denies any LOC and complains of severe lower back pain. On primary survey, HS demonstrates a patent airway and is hemodynamically stable. His secondary survey is otherwise negative. He complains of right lower extremity radicular pain and feels that he is not able to urinate.
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Hsu JM, Joseph T, Ellis AM. Thoracolumbar fracture in blunt trauma patients: guidelines for diagnosis and imaging. Injury. 2003;34:426–33.
Patel AA, Dailey A, Brodke DS, et al. Thoracolumbar spine trauma classification: the Thoracolumbar Injury Classification and Severity Score system and case examples. J Neurosurg Spine. 2009;10:201–6.
Patel AA, Whang PG, Brodke DS, et al. Evaluation of two novel thoracolumbar trauma classification systems. Indian J Orthop. 2007;41:322–6.
Vaccaro AR, Lehmann RA, Hurlbert RJ, et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine. 2005;30:2325–33.
Wood KB, Khanna G, Vaccaro AR, et al. Assessment of two thoracolumbar fracture classification systems as used by multiple surgeons. J Bone Joint Surg Am. 2005;87:1423–9.
Joaquim AF, Fernandes YB, Cavalcante RA, et al. Evaluation of the thoracolumbar injury classification system in thoracic and lumbar spinal trauma. Spine. 2011;36:33–6.
Whang PG, Vaccaro AR, Poelstra KA, et al. The influence of fracture mechanism and morphology on the reliability and validity of two novel thoracolumbar injury classification systems. Spine. 2007;32:791–5.
Agus H, Kayali C, Arslantas M. Nonoperative treatment of burst-type thoracolumbar vertebra fractures: clinical and radiological results of 29 patients. Eur Spine J. 2005;14:536–40.
Cantor JB, Lebwohl NH, Garvey T, et al. Nonoperative management of stable thoracolumbar burst fractures with early ambulation and bracing. Spine. 1993;18:971–6.
Chow GH, Nelson BJ, Gebhard JS, et al. Functional outcome of thoracolumbar burst fractures managed with hyperextension casting or bracing and early mobilization. Spine. 1996;21(18):2170–5.
Denis F, Armstrong GW, Searls K, et al. Acute thoracolumbar burst fractures in the absence of neurologic deficit. A comparison between operative and nonoperative treatment. Clin Orthop Relat Res. 1984;189:142–9.
Giele BM, Wiertsema SH, Beelen A, et al. No evidence for the effectiveness of bracing in patients with thoracolumbar fractures. Acta Orthop. 2009;80:226–32.
Mirza SK, Chapman JR, Anderson PA. Functional outcome of thoracolumbar burst fractures managed with hyperextension casting or bracing and early mobilization. Spine. 1997;22:1421–2.
Shen WJ, Liu TJ, Shen YS. Nonoperative treatment versus posterior fixation for thoracolumbar junction burst fractures without neurologic deficit. Spine. 2001;26(9):1038–45.
Thomas KC, Bailey CS, Dvorak MF, et al. Comparison of operative and nonoperative treatment for thoracolumbar burst fractures in patients without neurological deficit: a systematic review. J Neurosurg Spine. 2006;4(5):351–8.
Wood K, Buttermann G, Mehbod A, et al. Operative compared with nonoperative treatment of a thoracolumbar burst fracture without neurological deficit. A prospective, randomized study. J Bone Joint Surg Am. 2003;85-A(5):773–81.
Mumford J, Weinstein JN, Spratt KF, Goel VK. Thoracolumbar burst fractures. The clinical efficacy and outcome of nonoperative management. Spine. 1993;18(8):955–70.
Shen WJ, Shen YS. Nonsurgical treatment of three-column thoracolumbar junction burst fractures without neurologic deficit. Spine. 1999;24(4):412–5.
Dai LY, Jiang LS, Jiang SD. Conservative treatment of thoracolumbar burst fractures: a long-term follow-up results with special reference to the load sharing classification. Spine. 2008;33(23):2536–44.
Bailey CS, Dvorak MF, Thomas KC, et al. Comparison of thoracolumbosacral orthosis and no orthosis for the treatment of thoracolumbar burst fractures: interim analysis of a multicenter randomized clinical equivalence trial. J Neurosurg Spine. 2009;11(3):295–303.
Folman Y, Gepstein R. Late outcome of nonoperative management of thoracolumbar vertebral wedge fractures. J Orthop Trauma. 2003;17(3):190–2.
Vaccaro AR, Kim DH, Brodke DS, et al. Diagnosis and management of thoracolumbar spine fractures. Instr Course Lect. 2004;53:359–73.
McAfee PC, Yuan HA, Lasda NA. The unstable burst fracture. Spine. 1982;7(4):365–73.
Marco RA, Meyer BC, Kushwaha VP. Thoracolumbar burst fractures treated with posterior decompression and pedicle screw instrumentation supplemented with balloon-assisted vertebroplasty and calcium phosphate reconstruction Surgical technique. J Bone Joint Surg Am. 2010;92(1):67–76.
Tezeren G, Kuru I. Posterior fixation of thoracolumbar burst fracture: short-segment pedicle fixation versus long-segment instrumentation. J Spinal Disord Tech. 2005;18(6):485–8.
Hartmann F, Gercek E, Leiner L, Rommens PM, et al. Kyphoplasty as an alternative treatment of traumatic thoracolumbar burst fractures Magerl type A3. Injury. 2010: 10.
McCormack T, Karaikovic E, Gaines RW. The load sharing classification of spine fractures. Spine. 1994;19(15):1741–4.
Wang XY, Dai LY, Xu HZ, Chi YL. The load-sharing classification of thoracolumbar fractures: an in vitro biomechanical validation. Spine. 2007;32(11):1214–9.
Altay M, Ozkurt B, Aktekin CN, et al. Treatment of unstable thoracolumbar junction burst fractures with short- or long-segment posterior fixation in magerl type a fractures. Eur Spine J. 2007;16(8):1145–55.
Wang ST, Ma HL, Liu CL, et al. Is fusion necessary for surgically treated burst fractures of the thoracolumbar and lumbar spine?: a prospective, randomized study. Spine. 2006;31(23): 2646–53.
Mahar A, Kim C, Wedemeyer M, et al. Short-segment fixation of lumbar burst fractures using pedicle fixation at the level of the fracture. Spine. 2007;32(14):1503–7.
Wild MH, Glees M, Plieschnegger C, Wenda K. Five-year follow-up examination after purely minimally invasive posterior stabilization of thoracolumbar fractures: a comparison of minimally invasive percutaneously and conventionally open treated patients. Arch Orthop Trauma Surg. 2007;127(5):335–43.
Merom L, Raz N, Hamud C, et al. Minimally invasive burst fracture fixation in the thoracolumbar region. Orthopedics. 2009;32(4):273.
Fuentes S, Metellus P, Fondop J, et al. Percutaneous pedicle screw fixation and kyphoplasty for management of thoracolumbar burst fractures. Neurochirurgie. 2007;53(4):272–6.
Wood KB, Bohn D, Mehbod A. Anterior versus posterior treatment of stable thoracolumbar burst fractures without neurologic deficit: a prospective, randomized study. J Spinal Disord Tech. 2005;18(Suppl):S15–23.
Bohlman HH, Kirkpatrick JS, Delamarter RB, Leventhal M. Anterior decompression for late pain and paralysis after fractures of the thoracolumbar spine. Clin Orthop Relat Res. 1994;300:24–9.
Crutcher Jr JP, Anderson PA, King HA, Montesano PX. Indirect spinal canal decompression in patients with thoracolumbar burst fractures treated by posterior distraction rods. J Spinal Disord. 1991;4(1):39–48.
Kaneda K, Taneichi H, Abumi K, et al. Anterior decompression and stabilization with the Kaneda device for thoracolumbar burst fractures associated with neurological deficits. J Bone Joint Surg Am. 1997;79(1):69–83.
McCullen G, Vaccaro AR, Garfin SR. Thoracic and lumbar trauma: rationale for selecting the appropriate fusion technique. Orthop Clin North Am. 1998;29(4):813–28.
Ren Z, Jing Z, Pei F. Anterior decompression and reconstruction with internal fixation for severe thoracolumbar burst fracture. Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2006;20(4):397–9.
Sasso RC, Renkens K, Hanson D, et al. Unstable thoracolumbar burst fractures: anterior-only versus short-segment posterior fixation. J Spinal Disord Tech. 2006;19(4):242–8.
Parker JW, Lane JR, Karaikovic EE, Gaines RW. Successful short-segment instrumentation and fusion for thoracolumbar spine fractures: a consecutive 41/2-year series. Spine. 2000;25(9):1157–70.
Bradford DS, McBride GG. Surgical management of thoracolumbar spine fractures with incomplete neurologic deficits. Clin Orthop Relat Res. 1987;(218):201–16.
Whang PG, Vaccaro AR. Thoracolumbar fractures: anterior decompression and interbody fusion. J Am Acad Orthop Surg. 2008;16(7):424–31.
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Greenleaf, R., Harris, M.B. (2013). Lumbar Burst Fractures. In: Sethi, M., Jahangir, A., Obremskey, W. (eds) Orthopedic Traumatology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3511-2_4
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