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Thoracic Spine Injury, Sports Medicine

Kenneth Vitale, MD, FAAPMR Reviewed 04/2019
 


BASICS

DESCRIPTION

  • Thoracic spine fracture:

    • Rarely seen in sports but potentially catastrophic injury: higher risk in collision sports (e.g., hockey, football, wrestling)

    • The spinal column is divided int...

DIAGNOSIS

  • Rapid evaluation of airway, breathing, and circulation (ABCs)

  • Primary and secondary trauma survey

  • Detailed spine and neurologic exam, with specific attention to bony deformity or tenderness an...

TREATMENT

  • Thoracic spine fracture:

    • Stable fractures are often treated with brace immobilization (e.g., a thoracolumbosacral orthosis [TLSO] can immobilize a stable [<50% height loss] thoracic compre...

ONGOING CARE

PATIENT EDUCATION

Keys to prevent recurrence include postural correction, core strengthening, and teaching proper biomechanics. 

PROGNOSIS

Most thoracic injuries respond well to relative res...

REFERENCES

1
Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine (Phila Pa 1976).  1983;8(8):817–831.
2
Cornips EM. Crippling upp...

ADDITIONAL READING

  • Diaz JJr, Cullinane D, Altman D, et al. Practice management guidelines for the screening of thoracolumbar spine fracture. J Trauma.  2007;63(3):709–718.

  • Nannapaneni R, Marks SM....

CLINICAL PEARLS

  • 73% of thoracic herniations are asymptomatic; therefore, consider avoiding thoracic MRI during workup unless there is a concern for spinal cord injury.

  • Return to play only when the athl...

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