Injuries of the Thoracolumbar Spine from Tertiary Blast Injury in Thai Military Personnel during Conflict in Southern Thailand
Sompob Poopitaya MD*, Kris Kanchanaroek MD*
Affiliation : * Department of Orthopaedic Surgery, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
Background : There were higher numbers of tertiary blast injuries from terrorist bombing in southern
Thailand. There was no previous report about spinal trauma in tertiary blast injury.
Material and Method: Between January 2007 and December 2007, there were 100 Thai military personnel
injured in combat and 18 cases were classified to tertiary blast injury (type III). Six patients with spine and
back injuries were retrospectively reviewed.
Results : Incidence of injury to spine and back region was 6% of total blast injury and 33.3% of total tertiary
blast injury. There were 3 fractures of thoracolumbar spine (16.7%) and 3 sprain-strains of the thoracolumbar
spine (16.7%). One patient with flexion-distraction type of first lumbar spine and one patient with compression
fracture of third lumbar spine received conservative treatment. One patient with fracture-dislocation of L5/S1
with neurological deficit underwent spinal instrumentation and fusion. The back pain score returned to
normal in 9.3 weeks in the fracture group and 6 weeks in the back sprain-strain group.
Conclusion : The tertiary blast injury affected mostly in the back region. The uncommon flexion-dislocation
fracture of thoracolumbar spine with neurological deficit should be treated with spinal instrumentation and
fusion with excellent result. Other tertiary blast injury of back region can be treated with conservative
treatment.
Keywords : Blast injury, Tertiary blast injury, Military personnel, Thoracolumbar fracture
