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Orthopaedics
Thoracic and Lumbar Spine Trauma
Built from Orthopedic Trauma Essentials
What’s inside
7 sections · 74 slides
Overview
- What this topic covers
- Why the answers are not simple
Getting your bearings
Where these fractures happen, and what the words mean
- Regions of the spinal column
- Where “thoracolumbar” points to
- Parts of a single vertebra
- A lumbar vertebra from the side
- The back wall is the important wall
- A vertebral body crushed under load
- The labels A3 and A4
- What a burst fracture is
- How a burst fracture threatens the cord
- Burst fracture on a side-view CT scan
- The same burst fracture seen from above
- Canal narrowed on MRI
- A narrowed canal in a patient who feels fine
- The two routes on offer
- Rigid trunk brace
- Screws and rods placed from the back
- Posterior instrumentation on X-ray
- What pedicle screws changed
Brace it, or operate on it?
Type A3 and A4 fractures in a patient whose nerves still work
- “
- Why the question is still open
- Wood and colleagues: the randomised trial
- Wood and colleagues: the long look back
- Siebenga and colleagues: surgery looked better
- Vialle and Shen: back to no difference
- Alfaedi and colleagues: pooling it all
- Answer to question one
- Where question one leaves you
Short segment, or long?
How many levels to include when fixing one burst fracture
- “
- What the two constructs mean
- Why surgeons argue about it
- Short-segment and long-segment fixation compared
- The short-segment case up close
- The long-segment case up close
- Mak and colleagues
- Choudhury and colleagues
- Tammam and Ramkumar
- The pooled analysis
- Answer to question two
- Short against long, side by side
From the back, or front and back?
Choosing the surgical approach for a burst fracture
- “
- Three ways in
- Why anterior was the old favourite
- Why the posterior route gained ground
- The German multicentre study
- What the combined approach achieved
- What the combined approach cost
- Oprel and colleagues, 2010
- Tan and colleagues: the newer pooling
- Answer to question three
- The three approaches at a glance
Clear the canal, or leave it?
Canal compromise on the scan, in a patient with no symptoms
- “
- Direct and indirect decompression
- Why this is a genuine dilemma
- Yang and colleagues: check the ligament
- Patel and colleagues: how full is the canal?
- Others: judge it during the operation
- Ye Peng and colleagues: where the fragment sits
- Ye Peng and colleagues: the two triggers
- Aebli and colleagues: the strict line
- Answer to question four
- Two routes out of a compromised canal
The four answers together
What is settled, what is not, and how to decide anyway
- All four answers on one slide
- The pattern across all four questions
- So how do you actually decide?
- Terms worth keeping
- Quick revision check
- References
- References (continued)
- References (continued)
- References (continued)
- References (continued)
- Orthopedic Trauma Essentials 2026