Pediatric Thoracic 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
    — Thoracic spine fractures can occur after flexion injuries after football hit where player leads with his helmet
  • Imaging Radiograph:
    — Vertebral fractures are difficult to see on AP views of spine so lateral views always required
    — Thoracic spine radiographs may under-diagnose injury so if there is neurological deficit proceed to CT or MRI
  • Imaging CT: Sagittal reconstructions are important to look for spine fractures
  • DDX:
  • Complications:
  • Treatment:
  • Clinical:

Radiology Cases of Thoracic Spine Fracture

CT of thoracic spine fracture
Axial (left) and sagittal (right) CT without contrast of the thoracic spine show a fracture of the inferior endplate of the T8 vertebral body with a large fracture fragment extending posteriorly into the spinal canal and compressing the spinal cord.

Radiology Cases of Thoracic Spine Compression Fracture

CT of pediatric thoracic spine compression fractures
Coronal (left) and sagittal (middle) CT without contrast of the thoracic spine show loss of height of the T6 to T11 vertebral bodies which is also seen on the 3D CT (right).

Radiology Cases of Thoracic Spine Fracture with Spinal Epidural Hematoma

CT of thoracic spine fracture dislocation with epidural hematoma and cord compression
Coronal (left) and sagittal (middle) CT without contrast of the spine shows fracture of the T6 and T8 vertebral bodies with displacement at T7-T8. Sagittal T2 MRI without contrast of the spine (right) shows spinal stenosis and cord compression and abnormal cord signal and ligament disruption and an epidural hematoma at T7-T8.

Radiology Cases of Thoracic Spine Fracture of the Anterior and Posterior Columns

CT of pediatric thoracic spine fractures of the anterior and posterior columns of the spine
Contiguous sagittal CT without contrast of the thoracic spine show fracture lines through the anterior and posterior columns of the T7 through T10 vertebral bodies.