Tcrako - Mechanism of Formation in Lumbar Vertebra Fractures
Abstract
Fractures of the vertebral column are particularly important regarding neurological complications. Pathomechanism of the forces causing these fractures are important due to their role
from the point of the type of fractures, their treatment and complications. There are 5 mechanisms causing vertebral body fractures
A — When vertical compression force is loaded upon vertebra,
cartilaginous plate is fractured first and then cancelleous body
is crushed. If the forces go on to be increased the body is explosed.
There İractures are seen mostiy between T9 -L3.
B — Normally, flexion axis of the intervertebral joints of
lumbar vertebrae passes thru nuclevus pulposus. If the vertebra
is forced to hyperilexion around this axis the anterior part of
vertebral body, in front of the axis the anterior part of vertebral
body, in front of the axis is loaded, with a force 4 times greater
than the posterior part and the front part ol the vertebra body
crushes. While lateral force is added, lateral wedge fracture
OCCUİS.
C — Although posterior ligamentous complex ruptures by
pure flexion force, it can rupture due to flexion - rotation or stressed rotation. It the degree of flexion is great, pure dislocation
may occur. Under these forces, upper vertebra slides over the
lower one and carries the disc along and slice fracture of the
upper rim of the lower vertebral body occurs. These fractures
usually are unstable.
D — When patient's pelvis is fixed to his seat with seat belt,
his body is flexed due to flexion force and then traction forces
act upon posterior elements and vertebra fractures with 45 degree
angle in regard to the compression line. There fore vertebral body
and posterior elements are horizontalIy splitted.
E — Forced hyperextention ruptures anterior longitudinal
ligament. But, this could not be Shown experimentaliy. Cervical
vertebrae are more often İractures than the other parts of the column. If rotation force is added, ligaments easily rupture. In this type of İracture, posterior part of vertebral body, lamina and
pedicles fracture,
Keywords
References
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