Thoracic and lumbar vertebral trauma.

Injuries to the thoracic and lumbar vertebral column are common. They are all the result of increased loading on structures with limited flexibility. The majority of these injuries are related to hyperflexion. Plain radiography remains the mainstay of diagnosis of vertebral injuries. However, CT and MR imaging have important places in assessing patients with vertebral injuries. The radiographic assessment of these injuries is made easier by the fact that each injury occurs in a predictable and reproducible pattern that is defined by the mechanism. These features are termed the "fingerprints" of injury and indicate the full extent of damage. By recognizing the fingerprints and carefully evaluating the patient for abnormalities of alignment, bony integrity, cartilage or joint space, and soft tissues, it is possible to determine rapidly the full extent of injury and plan further evaluation and treatment. Instability may be assumed if there is displacement, widening of the interspinous space, widening of facet joints, widening of the interpediculate distance, or disruption of the posterior vertebral body line.