fracture (burst fracture, thoracolumbar)

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

Last reviewed 01/2018