What is a fracture in rocks where movement occurs?

All about vertibral fractures, their causes and treatment in the sports medicine field. Vertebral fractures occur most commonly in elderly individuals, persons with bone diseas…e, and those who have experienced significant trauma to the spine. Athletes in contact sports are also at risk.

Statistics demonstrate a bimodal age distribution of vertebral fractures, from 15-29 years and older than 65. Given the spinal column's anatomical diversity, not all areas are equally susceptible. The cervical spine is most commonly fractured given its flexibility; the TL junction is second most common, and thoracic fractures are least frequent.

Fractures are generally classified as either stable or unstable. The determination of stability is based upon the location(s) of the lesion in the vertebral body. The cervical spine is divided into anterior and posterior columns: a fracture to both columns (of the same level) is considered 'unstable.' The thoracic and lumbar spines are divided into three columns: anterior, middle, and posterior.

The Thoracolumbar Injury Classification and Severity Score (TLICS) was developed to aid in decisions regarding necessity of imaging and surgery. Criteria include: morphology of fracture, neurologic involvement, and posterior ligament complex involvement. Compression fractures are the most common form and are typically associated with osteoporosis or bone disease; therefore they are seen more often in older individuals.

These fractures often occur with flexion and may involve multiple levels. In healthy and younger individuals, spinal fractures are more likely following high-energy forces, such as motor vehicle accidents and blunt trauma. Other types of thoracolumbar fractures include burst, flexion-distraction, and translational.

Spinal cord injury may occur depending on the severity and type of fracture. On exam, pain can be elicited with palpation of the area and the patient may demonstrate limited range of motion. Neurologic impairments may be present initially; however, a high index of suspicion should be maintained in their absence, particularly if the mechanism of injury was exceptionally traumatic.