The diagnostic value of the anteroposterior radiograph for thoracolumbar spinal injuries

Identification of fractures of the posterior elements of thoracolumbar vertebrae is important because these fractures render the spine unstable. Technically it is difficult to demonstrate the posterior elements on a supine lateral radiograph in patients with multiple injuries. Careful inspection of the posterior vertebral structures on the anteroposterior view will reveal valuable information. Three radiological signs--interpediculate widening, increased interspinal distance and the appearance of 'Chance' fractures--are discussed.