thoracolumbar

Definition

Minimal trauma fracture

- secondary to osteoporosis

- wedge fractures

Epidemiology

F > M

More common in elderly patients

Uncommon in men < 75

- look for alternative diagnosis

DDx

Renal failure

Malignancy - metastasis

Infection

Clinically

Can present with pain

Options

Anterior

- thoracotomy

- thoracoabdominal

- abdominal

Posterior

Anterior Approaches

C2 - T2

- anterior cervical approach

- may have to split manubrium / sternotomy for lowest levels

T3 - T7

- thoracotomy

- patient on side left side up to avoid veins

Xray Assessment

A:  Alignment

B:  Bony

C:  Canal

D:  Disc

S:  Soft tissues

Goals of surgery

1.  Correct deformity

2.  Restore stability

3.  Decompress neural elements if required

MRI

Advantage

- defines level of conus

- may need anterior rather than posterior surgery if lesion above conus