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Assessment for thoracic or lumbosacral spinal injury

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Assessment for thoracic or lumbosacral spine injury

  • assess the person with suspected thoracic or lumbosacral spine injury using these factors:
    • age 65 years or older and reported pain in the thoracic or lumbosacral spine
    • dangerous mechanism of injury (fall from a height of greater than 3 metres, axial load to the head or base of the spine - for example falls landing on feet or buttocks, high-speed motor vehicle collision, rollover motor accident, lap belt restraint only, ejection from a motor vehicle, accident involving motorised recreational vehicles, bicycle collision, horse riding accidents)
    • pre-existing spinal pathology, or known or at risk of osteoporosis - for example steroid use
    • suspected spinal fracture in another region of the spine
    • abnormal neurological symptoms (paraesthesia or weakness or numbness)

  • on examination:
    • abnormal neurological signs (motor or sensory deficit)
    • new deformity or bony midline tenderness (on palpation)
    • bony midline tenderness (on percussion)
    • midline or spinal pain (on coughing)

  • on mobilisation (sit, stand, step, assess walking): pain or abnormal neurological symptoms (stop if this occurs)

Note that assessing children with suspected thoracic or lumbosacral spine injury is difficult and the child's developmental stage should be taken into account.

Carry out or maintain full in-line spinal immobilisation if indicated by one or more factors listed (1).


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