Acute injuries of the upper thoracic spine associated with paraplegia.

A review of 35 cases of acute injury of the upper thoracic spine associated with paraplegia was done. In 32, a fracture-dislocation was present; in two, there was a dislocation without associated fracture; and in one, neither fracture nor dislocation was identified. A total of 22 cases conformed to a pattern of injury consisting of anterior fracture dislocation with disruption of the intervening facets joints and various vertebral body fractures. Tomography was necessary for characterizationof the injuries. There was a 17% incidence of associated second level spinal injuries, usually a hyperextension injury of the cervical spine.