Thoracic Spinal Cord Compression Fx's commonly occur in the lower t-spine since the upper t-spine is stabilized by the rib cage attachments. Spinal cord compression fx's occur when the vertebral body of spinal cord collapse resulting in acute back pain that causes a decrease mobility and general health.
The most common motion that causes the vertebral body to collapse is a forward bend with downward pressure on the spinal column. Osteoporosis can also be a contributing factor to pts with t-spine compression fx's The osteoporotic t-spine can cause a pt's spine to form an exaggerated kyphotic curve of upper t-spine related to the back pain causing the shoulders to slump forward. Traumatic injuries such as an MVA, fall, or a forceful landing from a jump can all also cause t-spine compression fx's. Metastatic disease can also cause a t-spine compression fx. The spread of cancer to the vertebral body causes a weakening in the bony structure allowing a compression fx to present.
AP and Lateral radiographs are the best form of identifying t-spine compression fx's. This form of radiography is the best why to completely visualize the entire aspect of the vertebral body. Next, a multislice axial CT scan with reformats in the frontal and sagittal plane of the t-spine are useful to examine any pathology that may be affecting the spinal canal. MRI is used only in spinal cord compression fx pt's that have any resulting neurologic deficiencies. Lastly, an Nuclear Medicine bone scan may also be ordered to determine the age and nature of the t-spine compression fx.
Most t-spine compression fx are treated with pain medication, physical therapy, decreasing activity, bracing, and/or a form of surgical fixation.
Some t-spine compression fx may require the use of a vertebroplasty or kyphoplasty intervention. This procedure is done either in a surgical suite or in an interventional radiography suite. In a vertebroplasty, a medical grade cement is injected in the vertebral body at the site of the fx to stabilize the vertebrae in relieve pain. In a kyphoplasty, a balloon is inserted in the fx site in order to reinstate the original shape of the vertebral body, and then inject the medical grade cement into the vertebrae. This is also in efforts to rebuild the vertebral body to its original form and relieve pain.
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