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Re: Перелом IX грудного позвонка
John T. Ruth 23 Июнь 2003, 16:14
A CT would be helpful to determine if there is middle column involvement. Also it would help determine if the posterior interspinous ligament is intact (lack of interspinous widening. The available images appear to show an anterior column only injury. If other imaging tests confirm this combined with normal neurological function nonoperative treatment with a hyperextension brace or nothing is appropriate.
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    Re: Перелом IX грудного позвонка
    Carlo Bellabarba 23 Июнь 2003, 16:16
    Agreed, except that loss of posterior vertebral body height on the lateral radiograph suggests middle column involvement as well, and therefore a diagnosis of burst fracture. This is confirmed on the AP by (albeit subtle) widening of the pedicles at the level of injury. In keeping with this diagnosis, the lateral also suggests retropulsion of fracture fragments into the canal. I concur that unless there is associated facet subluxation or interspinous widening on CT (possible, but unlikely given the well-maintained alignment and given that on the AP radiograph the spinous processes seem reasonably equidistant) this is a stable burst fracture that I would treat with a TLSO for 3 months.
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