- Criteria for Stable Burst Frx:
- neurologically intact;
-
posterior arch remains intact:
- pedicle widening implies post arch disruption w/ instability;
- less than 25 to 35 deg of kyphosis;
- less than 50% anterior body height collapse:
- Discussion:
- if frx is stable, further collapse & retropulsion are unlikely;
- in stable bust frxs,
posterior column is uninjured & remains functional as tension band wheras
unstable burst frx have comminution or ligamentous damage to posterior column;
- this occurs with compression loading of the spine in which there is very little
flexion or rotation moment w/
posterior elements remaining intact;
- stable burst frx pattern shows a typical burst of the vertebral body but has intact
posterior elements, esp interspinous ligament;
- Treatment:
- w/ mild burst frx & absence of neurologic injury, non operative treatment is indicated;
- consider use of corrsette w/ rigid stays, Jewett brace, or hyperextension cast;
