Cervical burst fracture

Background

• Unstable if:
  • Associated neurologic deficits
  • Loss of >50% of vertebral body height
  • >20 degrees of spinal angulation
  • Compromise of >50% of spinal canal
  • Axial compression > nucleus pulposus forced into vertebral body

Differential Diagnosis

Vertebral fractures and dislocations types

Vertebral anatomy.

Numbering order of vertebrae.

• Cervical fractures and dislocations
  • Atlanto-occipital dissociation
  • C1
    • Jefferson fracture
    • C1 isolated anterior arch fracture
    • C1 isolated posterior arch fracture
  • C2
    • Odontoid fracture
    • Hangman's fracture
  • C3-C7
    • Cervical burst fracture
    • Cervical spinous process fracture
    • Extension cervical teardrop fracture
    • Flexion cervical teardrop fracture
    • Anterior cervical wedge fracture
  • Cervical facet dislocation
  • Isolated transverse process fracture
• Thoracic and lumbar fractures and dislocations
  • Chance fracture
  • Thoracic burst fracture
  • Lumbar burst fracture
  • Isolated transverse process fracture
  • Thoracic and lumbar compression fractures

Workup

• Imaging
  • Lateral x-ray - Comminuted body and loss of vertebral height
  • AP x-ray - Vertical fracture of the body

Management

• Prehospital Immobilization see NAEMSP National Guidelines for Spinal Immobilization

See Also

• Cervical spine injuries