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Stable Burst Fractures

- Criteria for Stable Burst Frx:
    - neurologically intact;
    - posterior arch remains intact:
         - pedicle widening implies post arch disruption w/ instability;
    - less than 25 to 35 deg of kyphosis;
    - less than 50% anterior body height collapse:

- Discussion:
    - if frx is stable, further collapse & retropulsion are unlikely;
    - in stable bust frxs, posterior column is uninjured & remains functional as tension band whereas unstable burst frx have comminution 
           or ligamentous damage to posterior column;
           - this occurs with compression loading of the spine in which there is very little flexion or rotation moment w/ posterior elements
                   remaining intact;
    - stable burst frx pattern shows a typical burst of the vertebral body but has intact posterior elements, esp interspinous ligament;

- Treatment:
    - w/ mild burst frx & absence of neurologic injury, non operative treatment is indicated;
    - consider use of corrsette w/ rigid stays, Jewett brace, or hyperextension cast