Burst Fractures and Orthoses

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Burst fractures start out frequently as anterior compression fractures.  The difference is that the bones actually break, explode, and go through and out, sometimes going into the spinal canal or the foramen.  It can cause numbness, tingling, and even spinal cord injury.  Burst fractures are carefully assessed.  If there is more than two columns involved, typically they are treated surgically or fixated surgically because of the potential damage to the spinal cord.  If the burst fractures are less risky or mostly stable, they can be treated with a custom molded or molded TLSO (Thoraic Lumbar Sacral Orthosis).  In a burst fracture, it is particularly important that we stop transverse rotation as well as a lot of lateral flexion.  We do not want those bone fragments to migrate into places we do not want them.  We arrest virtually all motion of the spine through the use of a custom molded body jacket or TLSO.  These are plastic devices and they are providing increasing intracavitary pressure because they consist of a circumferential wrap which provides equal compression all around, squeezing the soft tissues.  We typically add lordosis or take away lordosis in the lumbar section if we want to offload or unload the vertebral bodies or we can take out some of the lordosis if we want to offload the posterior section of the spine.