48/ F H/O fall from height of 10 feet, complaints of LBA. No other complaints Neurologically no deficits Paraspinal muscle and tenderness locally present What should be the plan of management?


It's l1 fracture if there's no neurologic deficit decompression in form of laminectomy and pedicle screw fixation only If there's a deficit anterior decompression also will be needed . Axial cuts needed also

Fracture with retropulsion causing compression of conus More than 50 percent wedging Unstable by three column concept Pedicle screw fixation spanning fracture Distraction will achieve reduction Laminectomy if needed to decompress or to facilitate reducing retropulsed fragments

Li#with displacement of L1 withcompressions of thecal sac. Needs ortho opinion for further management.

L1 fracture with retropulsion of fracture fragment causing cord compression decompression and fixation

Compression and fragmentation of body of L1. with maintained corresponding endplates and disc spaces. Compression fracture L1.

Why not anterior approach It’s a burst fracture with retropulsion of fracture segment with canal compromise and kyphotic deformity

Corpectomy with expandable cage fixation to correct the kyphosis and canal can also be decompressed as compression is anterior

As this is burst # LV1 with retropulsion of bone segment compressing underlying cord... Best to do.. anterior approach...corpectomy , excision of retropulsed segment and expendable cage ...(as only pedicle and screw fixation may lead to syrix formation later on...bcz of persisting trauma of cord from retropulsed segment)

L1 compression fracture with severe cord compression.. needs decompression and fixation as soon as possible

What approach

Compression # L1 with cord compression

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