Changing Patterns of Fracture in the Dorsal and Lumbar Spine

Abstract

Fractures and dislocations of the spine formed 1% of all fractures dealt with by the Oxford Accident Service over the decade 1947–57, injuries to the thoracic and lumbar spines forming just over three-fifths of these. Ten per cent of these patients suffered injury to the spinal cord and roots, the great majority being complete lesions. One-fifth of all patients suffered severe associated multiple injuries. Younger patients tended to incur more extensive fractures and more multiple injuries, and their vertebral fractures were concentrated at T 6. Older patients tended to have milder injuries and less extensive fractures, and tended to fracture at T 12. The majority of the patients with severe multiple injuries had mid-dorsal fractures. Evidence is presented in favour of the existence of two separate areas of stress concentration at mid-dorsal and at thoraco-lumbar levels. The pattern of injury to the thoracic and lumbar spine may be changing, probably because of the increasing importance of road accidents in their production. © 1966, British Medical Journal Publishing Group. All rights reserved.