title: Injuries of the thoracolumbar spine from tertiary blast injury in Thai military personnel during conflict in southern Thailand.
abstract: BACKGROUND
  There were higher numbers of tertiary blast injuries from terrorist bombing in southern Thailand. There was no previous report about spinal trauma in tertiary blast injury.
  
  
  METHODS
  Between January 2007 and December 2007, there were 100 Thai military personnel injured in combat and 18 cases were classified to tertiary blast injury (type III). Six patients with spine and back injuries were retrospectively reviewed.
  
  
  RESULTS
  Incidence of injury to spine and back region was 6% of total blast injury and 33.3% of total tertiary blast injury. There were 3 fractures of thoracolumbar spine (16.7%) and 3 sprain-strains of the thoracolumbar spine (16.7%). One patient with flexion-distraction type of first lumbar spine and one patient with compression fracture of third lumbar spine received conservative treatment. One patient with fracture-dislocation of L5/S1 with neurological deficit underwent spinal instrumentation and fusion. The back pain score returned to normal in 9.3 weeks in the fracture group and 6 weeks in the back sprain-strain group.
  
  
  CONCLUSIONS
  The tertiary blast injury affected mostly in the back region. The uncommon flexion-dislocation fracture of thoracolumbar spine with neurological deficit should be treated with spinal instrumentation and fusion with excellent result. Other tertiary blast injury of back region can be treated with conservative treatment.
authors.affiliation: Department of Orthopaedic Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand. sompob.phu@gmail.com
authors.forename: Sompob
authors.initials: S
authors.lastname: Poopitaya
authors.forename: Kris
authors.initials: K
authors.lastname: Kanchanaroek
mesh_terms: D000328:Adult; D001753:Blast Injuries / Q000145:classification / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D008875:Middle Aged; D008889:Military Personnel; D011859:Radiography; D012189:Retrospective Studies; D016103:Spinal Fractures / Q000601:surgery; D013785:Thailand / Q000453:epidemiology; D013904:Thoracic Vertebrae / Q000293:injuries*; D016896:Treatment Outcome; D014857:Warfare