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Case #22

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Demographics: 15 years old, Female
Indication: Trauma

Findings

  • Acute flexion-distraction injury centered at T12-L1 with focal kyphosis, splaying of the posterior elements, and widening of the T12-L1 facet joints
  • Acute three-column T12 fracture extends from the inferior endplate through the posterior elements with severely distracted bilateral pars interarticularis fractures. Retropulsion of the posterior inferior corner fracture fragment
  • Acute impaction fracture of the anterior superior corner of the L1 vertebral body
  • Acute mildly displaced bilateral L1 transverse process fractures

Diagnosis

Severe flexion-distraction injury

Sample Report

Acute flexion-distraction injury centered at T12-L1 with focal kyphosis, splaying of the posterior elements, and widening of the T12-L1 facet joints. Findings suggest extensive ligamentous injury, which can be further assessed with MRI.

Acute three-column T12 fracture extends from the inferior endplate through the posterior elements with severely distracted bilateral pars interarticularis fractures. Retropulsion of the posterior inferior corner fracture fragment at least partially effaces the ventral CSF. MRI could further assess for injury to the cord.

Acute impaction fracture of the anterior superior corner of the L1 vertebral body. Acute mildly displaced bilateral L1 transverse process fractures.

Discussion

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