Thoracolumbar injuries in the athlete

Acute thoracolumbar injury in the athlete can be a disabling condition that requires thorough evaluation and treatment. Although most thoracolumbar spine injuries are benign myofascial strains that respond well to nonsurgical management, the spectrum of injuries is broad and includes fractures and bony instability, ligamentous instability, and neurologic compromise. Evaluation of thoracolumbar injuries requires a rapid and focused evaluation at the time of injury to rule out catastrophic and neurologically threatening injuries; a detailed history and physical examination carried out at a later point in time should be paired with appropriate imaging studies. Initial radiographs may be combined with dynamic radiography, bone scanning, computed tomography, or magnetic resonance imaging to delineate the structural extent of injury. Acute treatment may be required and initiated at the time of injury; further treatment should be carried out once the nature and extent of the injury is fully understood. Nonoperative treatment is successful in most of the injuries. Operative treatment is applied in selected cases of structural instability or neurologic compromise.