Pars Fracture

Pars fractures, also know as pars defect, are fractures to the area of the vertebrae called the pars. The pars is in the posterior aspect of the vertebrae and connects the lamina and the transverse processes. Trauma or repeat injuries to the low back are what cause pars fractures. They are common in teens, especially gymnasts and football players. Commonly both pars are fractured, but it is possible that only one be fractured. Symptoms are low back pain, stiffness, tingling, numbness and weakness in the lower extremities. Diagnosis can be made in three ways, x-rays, CT scans, and nuclear medicine bone scans. Treatment starts with bracing and restricted activities. It symptoms persist, surgical treatment is necessary. Laminectomy and lumbar fusion are the two types of surgeries performed. A CT sagital image of an L5 pars fracture is shown above.

Thoracic Compression Fractures

Thoracic compression fractures are something that I am very familiar with because one of the radiologists that I work with regularly specializes in treatment of compression fractures. Compression fractures are when the vertebral body breaks and then collapses. This can occur in any vertebral body, but the thoracic spine is the most common area. It is typically caused by some sort of trauma to the spine, but can also be due to osteoporosis. Symptoms are severe back pain and kyphosis. Treatment varies depending on the severity of the fracture. Oral pain medication, bracing, physical therapy, osteoporosis treatment, and surgical procedures are all used as treatment. The surgical procedures are kyphoplasty and vertebroplasty. These surgeries treat the fracture by expanding the vertebral body with a balloon like device and then filling them with a form of hardening material that will work like a vertebral body. Typically other treatments are used along with surgical treatment. Surgery must be performed shortly after the fracture occurs or the body will start to repair the fracture on its own and surgery cannot be performed. Diagnosis is typically made with plain film x-ray but can also be better imaged on CT, and MRI. Included is a CT image of a thoracic compression fracture.