Male, 54 years old, with thoracic pain with fractures of T4, T5 and T6. Severe comminuted fracturing of the T5 vertebral body is demonstrated. Fracture fragments have been displaced laterally on both sides. There is complete loss of height anteriorly, and approximately 40% loss of height posteriorly.There is a small fracture of the anterior/inferior aspect of the T4 vertebral body. There is also a severe comminuted compression fracture of the T6 vertebral body. A fracture line is seen traversing the spinous process of T4 and to some degree the lamina, but the fracture fragments are not significantly displaced. At T5, the pars interarticularis on the right is fractured. A lucency is also evident within the left T7 pedicle which does not appear to be traumatic in nature and may simply represent fatty deposition or perhaps a hemangioma. There is, however, lucency through the right T6, T7 and T8 transverse processes compatible with fractures. As a result, there is a focal kyphotic angulation of the thoracic spine centered at the T4 through T6 region. The fractured vertebral bodies show mild retropulsion of vertebral body material, mostly at T5 and T6. This does not appear to significantly compromise the spinal canal, though MRI would provide a better assessment.Elsewhere, the bony spinal canal does not appear to be significantly compromised, though CT is insensitive for soft tissue encroachment. Likewise, except at the fractured levels, the bony neural foramina are preserved. At the level of fracturing, there is narrowing of the T5-6 and T6-7 neural foramina.Numerous rib fractures are identified involving at least T1 through T8 on the right and T1 through T6 on the left. These are at variable stages of repair given the presence of callus formation at some fracture sites.Bilateral small pleural effusions are seen.
1. Vertebral body fractures involving T4, T5 and T6, most severely affecting T5, with mild retropulsion of vertebral body material.2. Posterior element and/or transverse process fractures involving T4 through T8 as discussed above.3. Numerous bilateral rib fractures.