Demographics:
14 years old, Female
Indication:
Trauma
Findings
- Acute horizontally-oriented fracture extending through the L3 vertebral body and into the bilateral pedicles, pars interarticularis, and lamina as well as into the superior aspect of the L3 spinous process
- Additional nondisplaced sagittally-oriented fracture component in the midline of the vertebral body
- Associated anterior compression with approximately 25% vertebral body height loss and posterior distraction measuring up to 10 mm with widening of the L2-L3 interspinous distance
- Paraspinal edema/hematoma at the level of L3
Diagnosis
Chance fracture
Sample Report
Acute flexion-distraction injury at L3 with a three-column fracture (Chance fracture), anterior compression with approximately 25% vertebral body height loss, and distraction of the posterior elements with widening of the L2-L3 interspinous distance concerning for ligamentous injury. No bony retropulsion. MRI could further evaluate extent of ligamentous injury if clinically indicated.
Discussion