Abstract
Vertebral fractures, like fractures in the peripheral skeleton, occur, in predictable and reproducible patterns that are related to the kind of force applied to the affected bone. The same force applied to the cervical, thoracic, or lumbar column will result in injuries which appear quite similar. A review of 621 injuries to the vertebral column revealed that there are basically four mechanisms of injury: flexion, extension, shearing, and torque (rotation). These injuries may occur by themselves or in combination with one another. The severity and extent of damage produced by any mechanisms is dependent upon the incident force, the position of the patient at the time of injury, and the velocity of the patient. Thus, there is a pattern of recognizable signs which span the spectrum from mild soft tissue damage to severe skeletal and ligamentous disruption. These patterns are termed the “fingerprints” of the injury, and this presentation illustrates the four basic types of vertebral injury producing those “fingerprints.”
Similar content being viewed by others
References
Burke DC (1971) Hyperextension injuries of the spine. J Bone Joint Surg [Br] 53:3
Cintron E, Gilula LA, Murphy WA, Gehweiler JA (1981) The widened, disk space: a sign of cervical, hyperextension injury. Radiology 141:639
Clark WM, Gehweiler JA Jr, Laib R (1979) Twelve significant signs of cervical spine trauma. Skeletal Radiol 3:201
Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8:817
Ferguson RL, Allen BL (1984) A mechanistic classification of thoracolumbar spine fractures. Clin Orthop 189:77
Forsyth HF (1964) Extension injuries of the cervical spine. J Bone Joint Surg [Am] 46:1792
Gehweiler JA Jr, Clark WM, Schaaf RE, Powers B, Miller MD (1979) Cervical spine trauma: the common combined conditions. Radiology 130:77
Gehweiler JA Jr, Osborne RL Jr, Becker RF (1980) The radiology of vertebral trauma. Saunders, Philadelphia, p 91
Gehweiler JA, Daffner RH, Osborne RL Jr (1981) Relevant signs of stable and unstable thoracolumbar vertebral column trauma. Skeletal Radiol 7:179
Guerra J Jr, Garfin SR, Resnick D (1984) Vertebral burst fractures: CT analysis of the retropulsed fragment. Radiology 153:769
Holdsworth FW (1963) Fractures, dislocations, and fracture-dislocations of spine. J Bone Joint Surg [Br] 45:6
Holdsworth FW (1970) Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg [Br] 52:1534
Kilcoyne RF, Mack LA, King HA, Ratcliffe SS, Loop JW (1983) Thoracolumbar spine injuries associated with vertical plunges: reappraisal with computed tomography. Radiology 146:137
Lee C, Kim KS Rogers LF (1982) Triangular cervical vertebral body fractures: diagnostic significance. AJR 138:1123
Lee C, Kim KS, Rogers LF (1982) Sagittal fracture of the cervical vertebral body. AJR 139:55
Lee C, Rogers LF, Woodring JH, Goldstein SJ, Kim KS (1984) Fractures of the craniovertebral junction associated with other fractures of the spine: overlooked entity? AJNR 5:775
Miller MD, Gehweiler, JA, Martinez S, Charlton OP, Daffner RH (1978) Significant new observations on cervical spine trauma. AJR 130:659
Naidich JB, Naidich TP, Garfein C, Liebeskind AL, Hyman RA (197) The widened interspinous space: a useful sign of anterior cervical dislocation in the supine frontal projection. Radiology 123:113
Roaf R (1960) A study of the mechanics of spinal injuries. J Bone Joint Surg [Br] 42:810
Rogers LF, Thayer C, Weinberg PE, Kim KS (1980) Acute injuries of the upper thoracic spine associated with paraplegia. AJR 134:67
Shuman WP, Rogers JV, Sickler ME, Hanson JA, Crutcher JP, King HA, Mack LA (1985) Thoracolumbar burst fractures: CT dimensions of the spinal canal relative to postsurgical improvement. AJNR 6:337
Smith GR, Northrop CH, Loop JW (1977) Jumpers' fractures: patterns of thoracolumbar spine injuries associated with vertical plunges. Radiology 122:657
Whalen JP, Woodruff CL (1970) The cervical prevertebral fat stripe: a new aid in evaluating soft tissue space. AJR 109:445
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Daffner, R.H., Deeb, Z.L. & Rothfus, W.E. “Fingerprints” of vertebral trauma—a unifying concept based on mechanisms. Skeletal Radiol 15, 518–525 (1986). https://doi.org/10.1007/BF00361047
Issue Date:
DOI: https://doi.org/10.1007/BF00361047