THORACOLUMBAR SPINE ANATOMY AND PATHOLOGY

Burstfracture of L1 32–year old male

This specimen is from a 32–year–old carpenter who had sustained a typical burstfracture of L1 eight
months before his death by falling from the third story of a construction scaffold. This fracture had been
treated non–surgically with a Boston brace. After a short relatively pain–free period the patient developed
increasing, ultimately relentless pain over the region of the fracture. He was denied continued sick–leave
and any insurance compensation for this workplace accident and eventually he committed suicide. Both
serial sections and radiographs showed that the vertebral body had healed with a kyphotic angulation but
there was practically no encroachment on the size of the vertebral canal. This axial section through the
lower endplate of L1 and the L1–L2 disc shows the unexpected finding of an inveterated hematoma that
is represented by the black area in the center of the injured disc. There is a marked disruption of the
inner lamellae of the annulus fibrosus. The cartilaginous endplate and the lateral annulus are sectioned
tangentially and display no macroscopic abnormalities. The thecal sac is rounded and slightly triangular
and shows a perfectly normal arrangement of the postero– and anterolateral cauda equina root bundles
surrounding the distal conus medullaris.