Traumatic thoracolumbar facet instability: Characteristic imaging findings

Objective. To review imaging patterns and injury mechanisms in patients with thoracolumbar facet instability (TFI). Design. Imaging studies for thoracolumbar osseous injuries over a 2-year period were reviewed. Imaging findings, injury pattern and reported mechanism of injury were established for patients with TFI. Patients. One hundred and ten patients with thoracolumbar acute, osseous injuries were studied. Results. Eleven of 68 (16.2%) unstable thoracolumbar injuries demonstrated TFI. Seven (64%) of the eleven TFI patients were unrestrained occupants in a motor vehicle accident (MVA) and the remainder were involved in injuries dominated by blunt impact to the back. Only two (18%) had serious, permanent neurological deficits. Conclusion. TFI is a common injury pattern, particularly for unrestrained occupants in MVAs. Characteristic radiographic, CT and MRI findings are presented and correlated with the injury mechanism and clinical findings.