Location of impact; T11 to L2 being the
most susceptible to injury, due to the
transition from a rigid to a mobile zone
(7)
REASONS FOR THE MEDICAL
CARE RECEIVED
Pre viously, re st is indic ate d to the pa tie nt, in orde r t o perform t he relevant ex ami nations (X- ray and CT) an d
fac ilitate the ir evaluati on and diagnos is. On the oth er hand, rest hel ps to avoid co mplications in the medica l
int erventio n t o be perfor med (due to in fla mmation, pa in and instabi lit y of the bo ne structure, in this case t he L2
ver tebra). (3)
The surgica l i ntervention , w hich consis ted of a fixat ion and distra cti on of the f rac ture, was p erf ormed due t o t he
hig h collap se of the L2 v ert ebral body, th erefore, th is method allo ws the stabili zat ion of the aff ected verte bra ,
gre atly red uce s postopera tiv e complicat ion s, doesn`t gen erate a lon g h ospital sta y a nd provides a good degree of
cli nical im pro vement (4). In addition, it generates a go od treatmen t o f the inten se pain and av oid s neurologi cal
seq uels (2) . A lso, it is one of the mos t c ommon and u sed in cases o f t raumatic ve rte bral injuri es (4).
Following the tensegrity model, the fracture of the L2 vertebra
triggered a severe biomechanical imbalance, this affecting the
distribution of forces over the body and generating compensatory
adaptations in muscles, fascia and other structures in the whole body.
This caused alterations in the muscular tone and postural changes that
could lead to other problems. The surgery, done with nails, was to
realign the spine and restore stability and prevent complications.(9)(10)
TENSEGRITY
MODEL
RISK FACTORS
Age is important for the
prevalence of spinal injuries. Over
the age of 40 years, aging implies
loss of trabecular and cortical
bone, some changes generate
thinning of the trabeculae and
decrease in cortical thickness,
which makes it more susceptible to
injury (9).
Sport performed; Paragliding involves a
high risk of injury. 27.4 % suffer from a
spinal injury and 68 % of them were
injured on landing. (8)
The main risk factor for vertebral
fractures is high-impact trauma. falls
from great heights account for 38.8%
of vertebral fractures (7)
LUMBAR FRACTURE
Classification
Physiopathology
These are lesions in the lumbar vertebra that affect the
mechanical and neurological stability of the spine. They may be
caused by trauma or bone fragility (osteoporosis).(1)
Type A (compression)
Type B (distraction)
Type C (translocation).
Type A lesions may
affect a single vertebral
body, or may occur in
combination with type B
or C lesions.(2)
It is the combination of
axial compression and
flexion of the spine with
involvement of the anterior
and middle columns. The risk
of neurological damage
increases if the posterior
cortical wall of the vertebral
body is affected.
General Description
SIGNS AND SYMPTOMS(2)
SEVERE DORSAL
OR LUMBAR
PAIN.
SYMPTOMS DUE TO
NERVE
INVOLVEMENT.
INABILITY TO
PERFORM NORMAL
ACTIVITY.
SEVERE CASES,
NEUROLOGICAL
DAMAGE.
DIAGNOSTIC(2)
TREATMENT
X-RAYS: FIRST
CHOICE OF STUDY.
CT OR MRI: BETTER
EVALUATE BONE,
TISSUES, EDEMA AND
VERTEBRAL CANAL.
BONE DENSITOMETRY
AND BLOOD TESTS: IF
OSTEOPOROSIS IS
SUSPECTED.
Etiology
Traffic accidents (39.5%)
🚗
Falls (38.8%)
🏠
sports accidents.
violence or other traumas.
Non-traumatic causes (more common
in older adults):
Osteoporosis
🦴
Disc degeneration
Tumors and metastases
Infections
Metabolic or rheumatologic
diseases.
Chronic corticosteroid therapy.(1)
TREATMENT MAY BE CONSERVATIVE
(MEDICATION, ORTHOSIS AND REST). IF
PAIN PERSISTS, VERTEBRAL
CEMENTATION IS USED. IF THIS IS NOT
SUFFICIENT, OSTEOSYNTHESIS WITH RODS
AND SCREWS IS USED.
