High resolution CT of thoracolumbar fractures

Twenty-one patients with thoracolumbar spinal fractures were studied with computed tomography (CT). A vertebral body was involved in 20; 12 had additional fractures of the posterior elements. Five had multiple level injuries. Neurologic deficits occurred in nine and were more common in combined vertebral body and posterior element injury. Five patients had surgical exploration of the spinal canal. CT provided more information than plain films, which missed a vertebral body fracture in one of 20, spinal canal compromise in four of 17, and posterior element fracture in one of 12. CT showed the posterior element injuries in greater detail. CT with intrathecal contrast material showed dural tear in one case. Dural tears were found at surgery in two additional patients studied without intrathecal contrast. All three had lamina fractures and cauda equina symptoms. Prompt repair of associated nerve root herniation led to rapid recovery in two of these patients.