Thoracolumbar Spine Anatomy and Pathology - Burst Fracture

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
Academic University Hospital
Department of Orthopaedic Surgery
Uppsala, Sweden
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