Trauma to the upper thoracic spine: anatomy, biomechanics, and unique imaging features. AJR Am J Roentgenol

Department of Radiology, University of Iowa Hospitals and Clinics, Iowa City 52242.
American Journal of Roentgenology (Impact Factor: 2.73). 02/1993; 160(1):95-102. DOI: 10.2214/ajr.160.1.8416656
Source: PubMed


This review summarizes the anatomic and biomechanical features of the thoracic spine, which are different from those of the more mobile segments of the spine, and emphasizes their role in trauma. The distinguishing characteristics of the thoracic spine are the presence of the ribs and their articulations. The rib cage restricts motion and adds stiffness to the spine. During trauma, it provides the thoracic spine with additional strength and energy-absorbing capacity. Above the T10 level, most injuries produce a basic pattern consisting of an anterior fracture-dislocation involving two contiguous vertebrae, often with associated neurologic impairment. The definition of spinal instability remains controversial. CT is the imaging technique of choice for evaluation of spine fractures; however, MR imaging is superior in the evaluation of spinal cord injury and posttraumatic disk herniation. MR imaging also provides prognostic information not obtainable with other imaging methods.

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    • "From a biomechanical perspective, the surgeon must take into consideration the “four-column model” of thoracic stability [18,28,29] provided by the rib-cage and the thoracic spine, in conjunction with the shoulder balance provided by clavicular strut integrity [16,17,22,30,31]. The present case report outlines the biomechanical importance of the integrity of the “upper transthoracic cage” [4], based on the functional interaction between the shoulder girdle, the rib cage, and the thoracic spine. "
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