Management of non-contiguous vertebral fractures.
Non-contiguous vertebral fractures are not common. In 78 consecutive patients with acute thoracolumbar fractures, we found that 13 patients (16.7%) had non-contiguous spinal injuries. Five patients had a combination of cervical and thoracolumbar injuries and eight had a combination of thoracic and lumbar injuries. Four of the eight patients in the thoracic and lumbar group had posterior surgical stabilisation procedures. Two patients had instrumentation of all injured, non-contiguous vertebrae and healing occurred uneventfully, and two patients had instrumentation of only the major fracture and a progressive deformity occurred at the site of the minor fracture. We concluded that: patients with a spinal fracture should have radiographic evaluation of their entire spine to rule out non-contiguous fractures; if non-contiguous fractures are evident on standard radiographs, all levels of injury should be evaluated with computerised tomography; and all unstable or potentially unstable injuries should be reduced, stabilised, and fused.
D000328:Adult; D000368:Aged; D002574:Cervical Vertebrae / Q000293:injuries*; D005260:Female; D005593:Fracture Fixation, Internal; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000601:surgery; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013123:Spinal Fusion; D013904:Thoracic Vertebrae / Q000293:injuries*