What are the common injury mechanisms and types of thoracic and lumbar fractures seen in the pediatric population

Thoracic and lumbar fractures are rare in the pediatric population. Motor vehicle accidents, pedestrian-vehicle accidents, and falls are the most common injury mechanisms. The common fracture types are described as:

• Compression fractures: present with isolated loss of anterior vertebral body height due to an injury mechanism associated with flexion and axial loading.

• Burst fractures: present with loss of anterior and posterior vertebral body height due to an injury mechanism associated with axial loading. Retropulsion of bone into the spinal canal, posterior element fractures, posterior ligamentous injuries, and neurologic deficits may occur depending on the severity of injury.

• Flexion-distraction injuries: present as a three-columns spinal injury due to application of flexion-distraction forces relative to a fixed axis (e.g. seat-belt). Neurologic injury and abdominal injury are frequently associated with this injury pattern.

• Fracture-dislocations: present as the result of high-energy injury that completely disrupts the integrity of all three spinal columns and results in displacement of the spine in one or more planes. Severe neurologic injuries are associated with this fracture pattern.

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