Abdominal aortic injury associated with transverse lumbar spine fracture — Imaging findings

• Published in: Clinical radiology 1995-12, Vol.50 (12), p.834-838
• Main Authors: Reaney, S.M., Parker, M.S., Mirvis, S.E., Bundschuh, C.V., Luebbert, P.D., Vingan, H.L.
• Format: Article
• Language: English
• Subjects: Accidents, Traffic; Adolescent; Adult; Aorta, Abdominal - diagnostic imaging; Aorta, Abdominal - injuries; Biological and medical sciences; Female; Humans; Lumbar Vertebrae - diagnostic imaging; Lumbar Vertebrae - injuries; Magnetic Resonance Imaging; Male; Medical sciences; Seat Belts - adverse effects; Spinal Fractures - diagnostic imaging; Spinal Fractures - etiology; Tomography, X-Ray Computed; Traumas. Diseases due to physical agents; Vascular injuries: limbs, aorta, vena cava
• ISSN: 0009-9260; 1365-229X
• DOI: 10.1016/S0009-9260(05)83103-4

The association of abdominal aortic injury with transverse fractures of the lumbar spine is not well recognized. Three cases are presented with description of a mechanism common to both injuries that may explain this association — that of distraction and hyperflexion, such as occurs in seat-belt injuries. Whenever a transverse lumbar spine fracture following such a mechanism of injury is recognized, the co-existence of an injury to the abdominal aorta should be excluded by aortography if there is any doubt concerning the integrity of the peripheral pulses. This is best performed prior to laparotomy for any associated intraperitoneal injuries. Repeated clinical examination may detect deterioration in those cases with initially normal pulses. Ultimately, detection of the aortic injury rests on a high index of suspicion.