Posterior Elements: Burst Fracture



- Discussion:
    - typically the posterior column remains intact w/ a burst frx;
    - w/ severe injury, anterior angulation may damage posterior ligamentous ligament complex, creating an unstable burst frx;
    - w/ further axial loading, inferior facets of upper vertebrae wedge apart superior facets and pedicles of the fractured lower vertebral body;
           - result is saggital frx of lamina which either separates from base of the pedicles from the body or splits inferior body into right and 
                  left halves w/ their pedicles attached;

- Dural Tear:
    - w/ neurologic deficit in pt w/ burst frx & laminar frx, be aware that dural laceration w/ impaled nerve roots can be entrapped in 
          laminar fracture;

- Neural Injury:
    - w/ post elements injury, neurologic injury is present in 50% of cases;
    - neural injury may be caused by neural entrapment in laminar fractures



Original Text by Clifford R. Wheeless, III, MD.

Last updated by Data Trace Staff on Tuesday, December 27, 2011 4:10 pm