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The diagnosis is established by fracture typical imaging features of the lumbar spinal vertebrae. In a non-traumatic setting, there are often concomitant fractures 3 and they are often associated with: In traumatic injuries lumbar spine fractures can be associated with: The risk of osteoporotic fractures increases with age and they are more common in females 1. They are considered less severe and often managed conservatively 1.Traumatic fractures are more common in males. C2), and have no associated posterior translocation of the posterior vertebral body. A similar-appearing anteroinferior fracture fragment may occur in extension teardrop fracture however, the extension fractures more commonly occur in the upper cervical spine (e.g. The 'teardrop' fracture appearance is non-specific. Although milder cord injuries may be asymptomatic or have few neurological sequelae, injury with posterior column translocation, in particular, is associated with paralysis and quadriplegia 1. The long-term prognosis of this injury mostly depends on the degree of neurological injury. Due to the associated injury of both osseous and ligamentous structures, this fracture is usually unstable with almost all patients requiring decompression and internal fixation. The treatment and prognosis of flexion teardrop fractures are variable and depends on the degree of injury.

NB: the interspinous interval may be normal or even decreased following traction-immobilization.

evidence of posterior ligamentous rupture.

retropulsion of bone fragments which narrow spinal canal.

strongly correlates with degree of neurological injury 1,2.

degree of posterior translocation of lower vs upper spinal column at the level of injury.

The following should receive comment, whether present or absent: Given the spectrum of injury that occurs with flexion teardrop fracture, it is less important to label the findings as 'flexion teardrop' and more important to draw attention to clinically relevant information.

additional spinal fractures at other levels.

more common inferior to the posterior vertebral body fragment vs the anterior fragment.

intervertebral disc space narrowing ( discoligamentous injury).

anterior dislocation of the facet joints.

abnormal spinal alignment: often less apparent if imaging occurs after traction is performed.

vertebral body rotation with an AP diameter that appears smaller than on other levels.

sagittal fracture through the vertebral body.

loss of anterior height of the vertebral body.

variable fracture of the vertebral body.

posterior displacement of the posterior vertebral body relative to the intact inferior cervical columnĭepending on the fracture severity, additional findings may include:.

anterior fragment often minimally displaced.

larger fragments may not appear triangular.

classically a triangular fragment (teardrop sign).

fracture of the anteroinferior lip of vertebral body.

The most characteristic findings include: Radiographic featuresįlexion teardrop fractures most commonly occur at the mid/lower cervical spine, specifically at C4, C5, or C6 1,2.

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Less severe injuries manifest as incomplete patterns, and are less associated with neurological injury 1.

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The overall extent of injury is quite variable.

$chance fracture$

variable posterior translocation of the lower cervical column in relation to the upper column 1,2, often with focal kyphotic deformity these features, together with possible retropulsed fracture fragments, correspond to the characteristic anterior spinal cord injury.forward rotational force causing distraction along posterior elements and tensile rupture of posterior ligaments (e.g.fracture continuation through the vertebral inferior subchondral plate (endplate), with shearing/rotational injury of the posterior discoligamentous complex and rupture of posterior longitudinal ligament 1.shearing/compression fracture along the anterior vertebral body, isolating a (classically) triangular anterior fragment and with rupture of anterior longitudinal ligament.With the most severe injuries, there is a structural failure in a characteristic pattern: diving impact, deceleration during motor vehicle collision). The injury typically occurs from severe flexion and compression forces (e.g.

$chance fracture$

Chance fracture