Burst fracture of the thoracolumbar spine

Burst fractures of the thoracolumbar spine may be divided into three types:

• stable fractures with an intact posterior ligament:
  • despite their stability these fractures are treated in a plaster jacket because the posterior part of the vertebral body is close to the nerve roots and because they are painful
  • the jacket is applied with the spine in the neutral position
  • after six weeks the plaster jacket is replaced with a removable polythene jacket for a further six weeks
    
    
• fractures which cause paraplegia:
  • treated with a padded plastic support or surgical stabilisation
  • rehabilitation is begun without delay
    
    
• fractures with an incomplete neurological deficit:
  • fractures of this type are urgently decompressed anteriorly if the CT scan shows encroachment on the spinal canal
  • posterior fusion is then undertaken