•• Here we could see the man has presented with excruciating lower back pain following a motor vehicle accident in which he was restrained front seat passenger. As similar to any other trauma cases ,We are supposed to proceed with Advanced trauma Life support guidelines.
Here the primary survey, and FAST Scan were not evident with life threatening injuries. However, Secondary survey is evident with tenderness Over the L4 vertebra,Without focal neurological evidence.
Now, Possibility of the vertebral injury mandates the CT of the spine. This confirmed us the presence of compression fracture that appears to be stable.
When we look at the morphology and stability of the fracture and lack of neurological deficits ,We don't indicate the MRI imaging here. Neither there exist justification for the skeletal survey.
Considering the MANAGEMENT PART, conservative management is sufficient here, this includes the immobilisation and strict bed rest. We Avoid the Vertebroplasty and other Surgical procedures right now.As per some studies use of orthoses don't improve outcomes in these patients.
Further, When we consider the severity of his pain, Opioid analgesia is Advisable. We may convert to NSAID later on. Given the necessity of the immobilisation, venous Thromboembolism prophylaxis should be considered.
REFERENCE : CHANG VICTOR ,HOLLY LANGSTON, :Bracing of Thoracolumbar fractures.
•• ELNOANAMY HOSSAM : Percutaneous Vertebroplasty,A first line treatment in Traumatic non -Osteoporotic Vertebral compression fracture.
•• MCgrith Mathew Wong :Vertebral compression fracture, review on current management and Multimodal therapy.
•• Rajashekaran S ,Kanna Rishimugesh ,Shetty Ajoyprasad ,Management of thoracolumbar spine trauma an overreview.