Spine trauma involves injuries to the spinal cord and/or the spine elements. Polytrauma patients must be considered as having a spinal injury until all radiological evaluation has been carried out. Hypoxemia and hypotension can worsen spinal cord injury and should be promptly recognized and treated. Computed tomography (CT) scan is the best radiological modality for diagnosing a spinal fracture, but additional radiological exams may be necessary, such as magnetic resonance imaging (MRI). As a general rule, stable injuries may be managed nonsurgically, whereas unstable injuries require surgical treatment to avoid development of deformity, worsening pain, or neurologic injury. Ligamentous injuries, such as seen in spine dislocations, are often unstable lesions and require surgical treatment. Special attention should be taken when evaluating children and the elderly with spinal fractures.
KeywordsSpinal cord injury Traumatic spine injury Spinal fracture
Suggested Readings and References
- 2.Azhari S, Azimi P, Shahzadi S, Mohammadi HR, Khayat Kashani HR. Decision-making process in patients with thoracolumbar and lumbar burst fractures with thoracolumbar injury severity and classification score less than four. Asian Spine J. 2016;10(1):136–42. https://doi.org/10.4184/asj.2016.10.1.136.CrossRefPubMedPubMedCentralGoogle Scholar
- 12.Patel AA, Dailey A, Brodke DS, Daubs M, Harrop J, Whang PG, Vaccaro AR, Spine Trauma Study G. Thoracolumbar spine trauma classification: the Thoracolumbar Injury Classification and Severity Score system and case examples. J Neurosurg Spine. 2009;10(3):201–6. https://doi.org/10.3171/2008.12.SPINE08388.CrossRefPubMedGoogle Scholar
- 17.Silva OT, Sabba MF, Lira HI, Ghizoni E, Tedeschi H, Patel AA, Joaquim AF. Evaluation of the reliability and validity of the newer AOSpine subaxial cervical injury classification (C-3 to C-7). J Neurosurg Spine. 2016;25(3):303–8. https://doi.org/10.3171/2016.2.SPINE151039.CrossRefPubMedGoogle Scholar
- 19.Vaccaro AR, Koerner JD, Radcliff KE, Oner FC, Reinhold M, Schnake KJ, Kandziora F, Fehlings MG, Dvorak MF, Aarabi B, Rajasekaran S, Schroeder GD, Kepler CK, Vialle LR. AOSpine subaxial cervical spine injury classification system. Eur Spine J. 2015. doi: https://doi.org/10.1007/s00586-015-3831-3.
- 20.Vaccaro AR, Lehman RA Jr, Hurlbert RJ, Anderson PA, Harris M, Hedlund R, Harrop J, Dvorak M, Wood K, Fehlings MG, Fisher C, Zeiller SC, Anderson DG, Bono CM, Stock GH, Brown AK, Kuklo T, Oner FC. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine. 2005;30(20):2325–33.CrossRefGoogle Scholar
- 21.Vaccaro AR, Oner C, Kepler CK, Dvorak M, Schnake K, Bellabarba C, Reinhold M, Aarabi B, Kandziora F, Chapman J, Shanmuganathan R, Fehlings M, Vialle L, Injury AOSC, Trauma Knowledge F. AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine. 2013;38(23):2028–37. https://doi.org/10.1097/BRS.0b013e3182a8a381.CrossRefPubMedGoogle Scholar
- 25.Yacoub AR, Joaquim AF, Ghizoni E, Tedeschi H, Patel AA. Evaluation of the safety and reliability of the newly-proposed AO spine injury classification system. J Spinal Cord Med. 2015.1–6. doi: https://doi.org/10.1179/2045772315Y.0000000042.