Lumbar Fracture

A. #9. List two abnormalities seen on these radiographs (2 marks)

• 
  Fracture of the vertebral body / anterior and middle columns
  

• Retropulsion of the posterior wall of the vertebra into the spinal canal
  

• Widening of the interpedicular distance
  
  

(Any 2, 1 mark each)

B. #10. What is the most likely diagnosis? (2 marks)

• 
  Burst fracture of L1
  
  

C. #11. What is the likely cause of his lower limb weakness? (2 marks)

• 
  Compression of the conus and cauda equina at L1 (2 marks)
  
  

D. #12. In view of his leg weakness, what investigation would you do next and how would this investigation be helpful? (2 marks)

• 
  MRI whole spine (1 mark)
  

• Evaluate the extent of spinal conus and cauda equina compression and non-contiguous spinal fractures (1 mark)
  
  

E. #13. What are the treatment options? (2 marks)

• 
  Decompression and stabilization (1 mark)
  

• Internal fixation / spinal instrumentation (1 mark)