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01-03-2006 | Original Article

The incidence and distribution of burst fractures

Authors: Frank V. Bensch, Mika P. Koivikko, Martti J. Kiuru, Seppo K. Koskinen

Published in: Emergency Radiology | Issue 3/2006

Abstract

This study was conducted to assess occurrence and distribution of burst fractures as well as common accident mechanisms and the associated neurologic deficit. Using picture archiving and communications system, all emergency multidetector computed tomography studies over 34 months were retrieved and evaluated for burst fractures by two radiologists by consensus. Initial neurological findings were retrieved from patients’ medical records. One hundred fifty-two patients (112 male) with a total of 169 burst fractures were found. In both genders, the incidence of burst fractures peaked at the thoracolumbar junction and between levels T5 and T8. In 10% of cases, more than one burst fracture was seen, thereof 53% on noncontiguous levels. Main accident mechanisms were falls, traffic, and sports. Neurological deficit was highest in patients with burst fractures of the cervical spine, independent of accident mechanism, and lowest in thoracolumbar junction fractures. Burst fractures occur frequently in high energy traumas and are most commonly associated with falling and traffic accidents. Multiple burst fractures occur in 10% of cases, half thereof on noncontiguous levels.

Cassar-Pullicino VN (2002) Spinal injury: optimising the imaging options. Eur J Radiol 42:85–91CrossRefPubMed

Jelly LME, Evans DR, Easty MJ et al (2000) Radiography versus spiral CT in the evaluation of cervicothoracic junction injuries in polytrauma patients who have undergone intubation. Radiographics 20:251–259

Bensch FV, Kiuru MJ, Koivikko MP, Koskinen SK (2004) Spine fractures in falling accidents: analysis of multidetector CT findings. Eur Radiol 14(4):618–624CrossRefPubMed

Trivedi JM, Jones R, Hunt A (2002) Spinal trauma: therapy—options and outcomes. Eur J Radiol 42:127–134CrossRefPubMed

Starr JK, Hanley EN (1992) Junctional burst fractures. Spine 17(5):551–557PubMed

Floyd T (2001) Alpine skiing, snowboarding, and spinal trauma. Arch Orthop Trauma Surg 121:433–436CrossRefPubMed

Kiuru MJ, Koivikko MP, Koskinen SK (2002) Serious horse-riding accidents: imaging findings and evaluation with multi-slice CT. Emerg Radiol 9(4):213–218PubMed

Meves R, Avanzi O (2005) Correlation between neurological deficit and spinal canal compromise in 198 patients with thoracolumbar and lumbar fractures. Spine 30(7):787–791CrossRefPubMed

Hu R, Mustard CA, Burns C (1996) Epidemiology of incident spinal fracture in a complete population. Spine 21(4):492–499CrossRefPubMed

10.

Burke DA, Linden RD, Zhang YP (2001) Incidence rates and populations at risk for spinal cord injury: a regional study. Spinal Cord 39(5):274–278CrossRefPubMed

11.

Fehlings MG, Sekhon LH, Tator C (2001) The role and timing of decompression in acute spinal cord injury: what do we know? What should we do? Spine 26(24 Suppl):S101–S110CrossRefPubMed

12.

Bohlman HH (1985) Current concepts review: treatment of fractures and dislocations of the thoracic and lumbar spine. J Bone Joint Surg Am 67-A(1):165–169

13.

Wilcox RK, Boerger TO, Allen DJ et al (2003) A dynamic study of thoracolumbar burst fractures. J Bone Joint Surg Am 85-A(11):2184–2189PubMed

14.

Holdsworth FW (1963) Fractures, dislocations and fracture-dislocations of the spine. J Bone Joint Surg Br 45:6–20

15.

Saifuddin A, Noordeen H, Taylor BA et al (1996) The role of imaging in the diagnosis and management of thoracolumbar burst fractures: current concepts and a review of the literature. Skeletal Radiol 25:603–613CrossRefPubMed

16.

Atlas SW, Regenbogen V, Rogers LF, Kwang SK (1986) The radiographic characterization of burst fractures of the spine. AJR Am J Roentgenol 147:575–582PubMed

17.

Denis F (1984) Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop 189:65–76PubMed

18.

Daffner RH, Daffner SD (2002) Vertebral injuries: detection and implications. Eur J Radiol 42:100–116CrossRefPubMed

19.

Dai L (2001) Remodeling of the spinal canal after thoracolumbar burst fractures. Clin Orthop Relat Res 382:119–123CrossRefPubMed

20.

Leferink VJM, Nijboer JMM, Zimmermann KW et al (2003) Burst fractures of the thoracolumbar spine: changes of the spinal canal during operative treatment and follow-up. Eur Spine J 12:255–260PubMed

21.

Mohanty SP, Venkatram N (2002) Does neurological recovery in thoracolumbar and lumbar burst fractures depend on the extent of canal compromise? Spinal Cord 40:295–299CrossRefPubMed

22.

Borock EC, Gabram SG, Jacobs LM, Murphy MA (1991) A prospective analysis of a two-year experience using computed tomography as an adjunct for cervical spine clearance. J Trauma 31:1001–1005PubMedCrossRef

23.

Wilcox RK, Boerger TO, Hall RM et al (2002) Measurement of canal occlusion during the thoracolumbar burst fracture process. J Biomech 35:381–384CrossRefPubMed

24.

Berlin L (2003) CT versus radiography for initial evaluation of cervical spine trauma: what is the standard of care? AJR Am J Roentgenol 180:911–915PubMed

25.

Wintermark M, Mouhsine E, Theumann N, Mordasini P et al (2003) Thoracolumbar spine fractures in patients who have sustained severe trauma: depiction with multi-detector row CT. Radiology 227:681–689PubMed

26.

Novelline RA, Rhea JT, Rao PM, Stuk JL (1999) Helical CT in emergency radiology. Radiology 213:321–339PubMed

27.

Blackmore CC, Mann FA, Wilson AJ (2000) Helical CT in the primary trauma evaluation of the cervical spine: an evidence-based approach. Skeletal Radiol 29:632–639CrossRefPubMed

28.

Rydberg J, Buckwalter KA, Caldemeyer KS et al (2000) Multisection CT: scanning techniques and clinical applications. Radiographics 20:1787–1806PubMed

29.

Fontijne WP, de Klerk LW, Braakman R et al (1992) CT scan prediction of neurological deficit in thoracolumbar burst fractures. J Bone Joint Surg Br 74(5):683–685PubMed

30.

Silver JR (2002) Spinal injuries resulting from horse riding accidents. Spinal Cord 40:264–271CrossRefPubMed

31.

Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3(4):184–201CrossRefPubMed

Title: The incidence and distribution of burst fractures
Authors: Frank V. Bensch
Mika P. Koivikko
Martti J. Kiuru
Seppo K. Koskinen
Publication date: 01-03-2006
Publisher: Springer-Verlag
Published in: Emergency Radiology / Issue 3/2006
Print ISSN: 1070-3004
Electronic ISSN: 1438-1435
DOI: https://doi.org/10.1007/s0010140-005-0457-5

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The incidence and distribution of burst fractures

Abstract

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