General Considerations for the Thoracic Spine
- It is important to trace the outline of each vertebral body, pedicle, transverse process
and spinous process for any discontinuity. The distance between the pedicles should be checked on the AP view
to assess the integrity of the ring. One should also follow the smooth alignment of the vertebral bodies for
any step-off or abrupt angulation.
- Injuries in the thoracolumbar spine can be classified by mechanism of injury: hyperflexion, vertical compression
or shearing injury. Hyperflexion injuries are most common and associated with anterior compression and wedging with
posterior distraction. Vertical compression injuries decrease the height of the body diffusely with possible retropulsion
of fragments into the spinal canal. Shearing injuries are associated with anterior dislocation and may show disruption
of the posterior and middle columns, making them unstable.
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