Abstract
Orthopedic surgeons or neurosurgeons manage most acute fractures of the spine. Knowledge of the signs of fracture instability is the key to appropriate selection of fractures that can be managed safely by primary care clinicians. Cervical spine fractures are nearly always the result of significant trauma and are frequently unstable. Cervical spine injuries are common in children, and the inherent ligamentous laxity allows the child’s spine to absorb and dissipate forces, leading to fewer serious spinal injuries. Thoracolumbar spine fractures are more common than fractures of the cervical spine. Younger patients fracture their thoracolumbar spine after a high-energy force, but fractures in elderly patients may occur secondary to minimal or no trauma because of underlying osteoporosis. Osteoporotic compression fractures are probably the most common type of spine fracture encountered in the office setting.
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