Acute thoracic and lumbar injuries

Abstract

Most injuries to the thoracic and lumbar spine represent muscle strain or contusion and are self-limited. However, it is important to identify more serious conditions that may require treatment. Sports that demonstrate increased risk for back injuries include gymnastics and football; however, back injuries occur in many sports. Risk factors for lumbar injury and back pain include prior back injury, decreased range of motion, improper technique, abrupt increases in training, and poor conditioning. The evaluation of a patient with an acute lumbar or thoracic spinal injury starts with a thorough history and exam. Plain radiographs are commonly used and can detect the majority of significant injuries, but other imaging modalities are variably used depending on the mechanism of injury, exam findings, and suspected injury. Muscle strains are the most common injury, but a variety fractures and disc herniations may also occur. This chapter discusses the most commonly encountered thoracic and lumbar injuries affecting athletes, focusing on the presentation, relevant examination and radiographic assessment, and guidelines for treatment and return to play.