Immediate hospitalization is required, as such injuries may result in varying degrees of spinal cord injury with possible paralysis. X-rays and MRIs are taken to determine whether the<unk>  can be managed with or without surgery. Surgical management is required when the<unk>  is unstable. Predicting spinal instability of vertebral thoracic lumbar<unk> s is based on several radiologic and clinical parameters. Efforts to refine<unk>  classification schemes to better predict instability continue. Application of axial zone model proposed by physicians at Barrow Neurological Institute may enhance the ability to predict stability, depending not only on the number of columns, but also on the number of zones involved in the injuries. Further clinical and biomechanical studies are warranted to validate this model. Different surgical treatments are available, the most common involving fusion of the remaining vertebra in the traumatized area, and removal of the larger loose vertebra pieces. A "spinal fusion" surgery entails two or more vertebra are permanently immobilized through surgery using titanium implants. Another less common technique is to replace the<unk>  vertebra with an artificial bone or cadaver bone. Both latter strategies have been used successfully in elderly subjects, and has not yet been attempted in younger subjects due to the unknown stability over the long term. Nonsurgical management is possible when the<unk>  subject is intact neurologically. Nonsurgical treatment involves the use of a full-body, exterior brace, normally a thoracic lumbar sacral orthosis (TLSO), often custom-molded to the subject's body. X-rays and MRIs are again taken with the subject every 2 weeks in the TLSO to determine whether the spine will remain stable. The TLSO is worn for 2–3 months 24/7. The subject undergoes several months of physical therapy to strengthen atrophied muscles and basically learn how to walk again. It is probable that the subject may exhibit some spinal dislocation after removal of the TLSO, and it is well within expected parameters with little neurological impact experienced by month 3. If no further major dislocation or subluxation occurs, no other external stabilization may be required.
Burst fracture
Rolando fracture
Duverney fracture
Avulsion fracture
Holdsworth fracture
Smith fracture
Bumper fracture
Chance fracture