Pediatric Lumbar Spine Fracture

  • Etiology:
    — Vertebral compression fractures can occur as result of trauma or osteoporosis (often from medications) or metastatic disease
    — Vertebral body compression fractures and vertebral body burst fractures caused by axial loading injuries
  • Imaging Radiograph: Vertebral fractures are difficult to see on AP views of spine so lateral views always required
  • Imaging CT: Sagittal reconstructions are important part of trauma CT to look for spine fractures
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:

Radiology Cases of Lumbar Spine Fracture

Radiology Cases of Anterior Compression Fractures of the Lumbar Spine

CT of multiple compression fractures in the lumbar spine
Sagittal CT without contrast of the lumbar spine (left) shows anterior compression fractures of the T12 thru L3 vertebral bodies with corresponding loss of height in each which is more subtly appreciated on the 3D CT (right).

Radiology Cases of Anterior and Posterior Compression Fractures of the Lumbar Spine

CT of lumbar spine fracture of L1 vertebral body
Sagittal CT without contrast of the lumbar spine (left) shows a compression fracture of the L1 vertebral body with fracture fragments off of the anterior and posterior aspects of the L1 vertebral body and a mild compression fracture of the L3 verebral body. Sagittal T2 MRI without contrast of the lumbar spine (right) shows the posterior fracture fragment off of L1 to be effacing the thecal sac anteriorly and causing compression of the spinal cord. There is also bright signal in the L1 vertebral body secondary to the compression fracture.

Radiology Cases of Chance Fracture of the Lumbar Spine

Radiograph of Chance fracture
AP (left) and lateral (right) radiographs of the lumbar spine show a three column fracture of the L3 vertebral body.
CT of anterior and posterior column fractures of the lumbar spine
Sagittal CT without contrast of the lumbar spine shows a fracture of the anterior and posterior columns of the L1 vertebral body and fractures of the anterior columns of the L2 and L3 vertebral bodies.
CT of Chance fracture of L1 vertebral body
Coronal (above left), sagittal (above right) and axial (below) CT without contrast of the lumbar spine shows a flexion distraction fracture of the L1 vertebral body and its posterior elements and a compression fracture of the L4 vertebral body.
CT of Chance fracture in lumbar spine
Sagittal CT without contrast of the lumbar spine (left) shows anterior wedging of the L1 and L2 vertebral bodies and a horizontal fracture through the spinous process of the L1 vertebral body. 3D CT from the left (middle) and right (right) show bilateral L1-L2 facet distraction resulting in a focal kyphosis at L1-L2.