Traumatismes du rachis et de la paroi thoracique

Emergency and Trauma Imaging of the Thoracolumbar Spine

“…10 The classic imaging finding is of a wedge-shaped vertebral body compressing the anterior cortex and sparing the middle and posterior columns. 45 The wedge is particularly visible on the lateral radiograph. Radiologic stability is best assessed by CT that will verify the integrity of the posterior wall and of the vertebral arch, the exact amount of loss of vertebral body height, and the fracture line.…”

“…The burst fracture represents 1.5% of all spine fractures and 14% of the thoracic and lumbar spine fractures. 45 Most commonly it occurs at the thoracolumbar junction, especially T12 and L1. The mechanism of injury is typically a vertical force producing a pure axial loading and is distinguished from an anterior wedge compression fracture by a comminuted fracture involving both the superior and inferior vertebral plates, together with a retropulsed bone fragment from the posterior cortex of the vertebral body (i.e., middle column), which is displaced into the spinal canal and may cause compression or even disruption of the neural structures.…”

“…Diskoligamentous injuries have a poor prognosis for healing unless surgical treatment is performed. 45…”

“…They are often associated with neurologic lesions (53-93% of patients develop permanent neurologic injury). 45 CT shows vertebral column discontinuity and olisthesis at the level of injury, involving all columns, complete disruption of the intervertebral disk, or horizontal fracture through the vertebral body with displacement and/or rotation. Horizontal fracture through the facets with anterolisthesis and fracture through the neural arch may also be demonstrated.…”