Thoracolumbar spine injuries

1. Three-column model of Denis. This is applicable to children and the most common pattern of injury is compression. Burst fractures, flexion distraction fractures (Chance) and fracture-dislocations all occur. Treatment is similar to that in the adult and in children of < 10 years the vertebral height often reconstitutes.

2. Vertebral apophysis. This can fracture and displace into the spinal canal, with associated disc protrusion. This usually occurs in the lower lumbar spine and is often misdiagnosed as a prolapsed intervertebral disc. Laminotomy and removal of fragments from the spinal canal are required.

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