This specimen is from a 32–year–old
carpenter who had sustained a typical burstfracture of L1 eight
months before his death by falling from the third story of a
construction scaffold. This fracture had been treated non–surgically
with a Boston brace. After a short relatively pain–free period the
patient developed increasing, ultimately relentless pain over the
region of the fracture. He was denied continued sick–leave and any
insurance compensation for this workplace accident and eventually he
committed suicide. Both serial sections and radiographs showed that
the vertebral body had healed with a kyphotic angulation but there
was practically no encroachment on the size of the vertebral canal.
This axial section through the lower endplate of L1 and the L1–L2
disc shows the unexpected finding of an inveterated hematoma that is
represented by the black area in the center of the injured disc.
There is a marked disruption of the inner lamellae of the annulus
fibrosus. The cartilaginous endplate and the lateral annulus are
sectioned tangentially and display no macroscopic abnormalities. The
thecal sac is rounded and slightly triangular and shows a perfectly
normal arrangement of the postero– and anterolateral cauda equina
root bundles surrounding the distal conus medullaris.
©2000 Wolfgang Rauschning, M.D., Ph.D.
Professor of Clinical Anatomy
Department of Orthopaedic Surgery
Reproduction without permission is prohibited http://www.akademiska.se/