Demographics:
30 years old, Male
Indication:
Trauma
Findings
- T6: Acute nondisplaced fracture with buckling of the anterior cortex and extension through the inferior endplate. No height loss or involvement of the posterior elements
- T7: Nondisplaced fractures of the superior articular facets with extension into pedicles and facet joints
- T8: Acute comminuted fracture with minimal anterior height loss with fracture extension into the posterior elements bilaterally to involve the pars interarticularis, superior articular facets, and transverse processes
- T12: Acute distracted avulsion fracture from the inferior margin of the spinous process
- L1: Acute chance fracture with a displaced anterior superior corner fracture fragment, approximately 10% anterior height loss, and fracture extension through the posterior elements bilaterally. Additional fractures of the transverse processes and spinous process. Focal kyphosis at this level with posterior bowing of the posterior cortex of the vertebral body
- L2: Acute mildly displaced fractures through the bilateral transverse processes and pedicles
- Extensive paravertebral edema throughout the mid and lower thoracic spine
- Multiple posterior rib fractures
- Right greater than left pulmonary contusion/aspiration. Debris layering in the central airways
- Left mainstem intubation
Diagnosis
Multilevel flexion-distraction injuries
Sample Report
Multilevel flexion-distraction mechanism of injury with fractures of the T6-T8 and L1-L2 vertebral bodies as well as of the T12 spinous process. Three-column fractures at T8 and L1 (chance-type) with mild associated anterior height loss but no associated subluxation, facet malalignment, or splaying of the spinous processes. No bony retropulsion. Slight focal kyphosis at L1.
Multiple posterior rib fractures with right greater than left pulmonary contusion/aspiration.
Left mainstem intubation. Recommend retracting the endotracheal tube 3 cm.
Discussion