Dr. Kevin Yip

Dr Kevin Yip
Orthopaedic Surgeon
MBBS(UK), FRCS(EDIN), FAM(SING), FHKCOS(ORTHO)

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Thoracic and Lumbar Spine

Fractures of thoracic and lumbar vertebrae

Fractures of vertebrae in the thoracic and lumbar regions are uncommon in sports, but can occur in riders, alpine skiers, ski-jumpers, and participants in contact sports

Symptoms and diagnosis

– Severe pain is felt at the site of the fracture.
– Pain is triggered by any back movement.
– If pain radiates into the legs it must be assumed that the spinal cord or its nerve roots have been affected.
– Loss of sensation and paralysis are signs of a serious injury.

Treatment

– The injured person must be taken to hospital for a neurological examination and an X-ray (and if needed a CT or MRI scan) to assess the stability of the vertebral column and other damage.
– When thoracic and lumbar vertebrae have been damaged during sporting activity, compression of the damaged vertebral body is usually only moderate and heals after a period of rest.
– In extreme cases, severe compression of the vertebrae may occur, and injury may also be caused to the spinal cord and nerve roots. These injuries are treated with bed rest, perhaps with a stabilizing brace or other immobilization, for 2–3 months, or with surgery.

Fractures of the transverse processes of the lumbar vertebrae

Fractures of the transverse processes of the vertebrae can result from direct violent impact to the side of the vertebral column, or from tearing in cases of muscle injury, especially in the lumbar region.

Symptoms and diagnosis

– Tenderness is felt over the transverse processes at the side of the vertebral column.
– Pain occurs on movement, especially when the back is bent sideways.
– An X-ray examination confirms the diagnosis.

Treatment

The athlete should rest until the pain has resolved. The injury is benign and heals in 6–8 weeks.

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