Can you tell me what is a flexion-distraction injury of the spine? We just got word that my brother is in the operating room right now with this problem as a result of a car accident.

Flexion-distraction injuries (FDI) of the spine occurs as a result of high-energy forces applied to the trunk (and spine). Usually there is a flexion force against the chest strong enough to break the back. The distraction force can dislodge the facet (spinal) joints enough to cause them to cross over each other and get locked.

Most often there are other injuries as well. The chest and lungs can be damaged at the same time the spine is injured. In the case of a car accident, the lap belt can cause additional abdominal injuries.

A flexion-distraction injury at the junction of the thoracic and lumbar spine (T12-L2) is called a Chance fracture. The fracture was first described by Dr. G. Q. Chance in 1948. Chance fractures were more common before the advent of lap and shoulder seat belts in the 1980s.

Samuel Abraham Joseph, Jr, MD, et al. The Successful Short-Term Treatment of Flexion-Distraction Injuries of the Thoracic Spine Using Posterior-Only Pedicle Screw Instrumentation. In Journal of Spinal Disorders & Techniques. May 2008. Vol. 21. No. 3. Pp. 192-198.

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