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Burst fracture of the fifth lumbar vertebra (with report of six cases)

ZHANG Jian nian,YANG Qi xiong.Department of Radiology,Jinchang No.1 Hospital,Gansu 737109,P.R.China  
Objective:To study the spinal stability in the burst fracture of the fifth lumbar vertebra and significance of the surgical treatment.Methods:Radiographic and CT cata of 6 cases with L 5 burst fracture were analyzed. The patients were followed up 6~24 months,and the degree of the vertebral wedging,degree of lordosis, and the continuity of posterior vertebral body line (PVBL) were observed. Results:In all six cases there was involvement of two or three vertebral columns.There was slight narrowing of spinal canal in one case and moderate narrowing in five;two cases had radicular functional deficits,and one case had diminution of degree of lordosis.There was posterior displacement of the vertebra,and also discontinuity of PVBL.After surgical (n=1) and conservative (n=5) management and follow-up 6~24 months,there was no progression of the degree of the vertebral wedging,degree of lordosis and PVBL as compared with that shown in the time of injury. The radicular function had well improved.Conclusion:L 5 burst fractures usually involve two or three vertebral columns and accompanies with narrowing of the spinal canal.They are usually stable injuries.The degree of spinal stenosis,compression of the nerve root by the bony fragment and progression of nerve root deficits are the indications of surgical management. Imaging examinations combined with clinical findings play an important role in the treatment planning.
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