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Orthopaedics

Thoracic and Lumbar Spine Trauma

Built from Orthopedic Trauma Essentials

The first 25 slides of Thoracic and Lumbar Spine Trauma
The first 25 slides, exactly as they appear. The full deck has 74 content slides.

What’s inside

7 sections · 74 slides

  1. 01

    Overview

    • What this topic covers
    • Why the answers are not simple

    2 slides

  2. 02

    Getting your bearings

    Where these fractures happen, and what the words mean

    • Regions of the spinal column
    • Where “thoracolumbar” points to
    • Parts of a single vertebra
    • A lumbar vertebra from the side
    • The back wall is the important wall
    • A vertebral body crushed under load
    • The labels A3 and A4
    • What a burst fracture is
    • How a burst fracture threatens the cord
    • Burst fracture on a side-view CT scan
    • The same burst fracture seen from above
    • Canal narrowed on MRI
    • A narrowed canal in a patient who feels fine
    • The two routes on offer
    • Rigid trunk brace
    • Screws and rods placed from the back
    • Posterior instrumentation on X-ray
    • What pedicle screws changed

    18 slides

  3. 03

    Brace it, or operate on it?

    Type A3 and A4 fractures in a patient whose nerves still work

    • Why the question is still open
    • Wood and colleagues: the randomised trial
    • Wood and colleagues: the long look back
    • Siebenga and colleagues: surgery looked better
    • Vialle and Shen: back to no difference
    • Alfaedi and colleagues: pooling it all
    • Answer to question one
    • Where question one leaves you

    9 slides

  4. 04

    Short segment, or long?

    How many levels to include when fixing one burst fracture

    • What the two constructs mean
    • Why surgeons argue about it
    • Short-segment and long-segment fixation compared
    • The short-segment case up close
    • The long-segment case up close
    • Mak and colleagues
    • Choudhury and colleagues
    • Tammam and Ramkumar
    • The pooled analysis
    • Answer to question two
    • Short against long, side by side

    12 slides

  5. 05

    From the back, or front and back?

    Choosing the surgical approach for a burst fracture

    • Three ways in
    • Why anterior was the old favourite
    • Why the posterior route gained ground
    • The German multicentre study
    • What the combined approach achieved
    • What the combined approach cost
    • Oprel and colleagues, 2010
    • Tan and colleagues: the newer pooling
    • Answer to question three
    • The three approaches at a glance

    11 slides

  6. 06

    Clear the canal, or leave it?

    Canal compromise on the scan, in a patient with no symptoms

    • Direct and indirect decompression
    • Why this is a genuine dilemma
    • Yang and colleagues: check the ligament
    • Patel and colleagues: how full is the canal?
    • Others: judge it during the operation
    • Ye Peng and colleagues: where the fragment sits
    • Ye Peng and colleagues: the two triggers
    • Aebli and colleagues: the strict line
    • Answer to question four
    • Two routes out of a compromised canal

    11 slides

  7. 07

    The four answers together

    What is settled, what is not, and how to decide anyway

    • All four answers on one slide
    • The pattern across all four questions
    • So how do you actually decide?
    • Terms worth keeping
    • Quick revision check
    • References
    • References (continued)
    • References (continued)
    • References (continued)
    • References (continued)
    • Orthopedic Trauma Essentials 2026

    11 slides