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143: SPINAL FRACTURE

Jennifer Cabrera, DPT, GCS; Eric Shamus, PhD, DPT, PT, CSCS

CONDITION/DISORDER SYNONYM

  • Vertebral compression fracture

ICD-9-CM CODES1

  • 805.0 Closed fracture of cervical vertebra without mention of spinal cord injury

  • 805.1 Open fracture of cervical vertebra without mention of spinal cord injury

  • 805.2 Closed fracture of dorsal (thoracic) vertebra without spinal cord injury

  • 805.3 Open fracture of dorsal (thoracic) vertebra without spinal cord injury

  • 805.4 Closed fracture of lumbar vertebra without spinal cord injury

  • 805.5 Open fracture of lumbar vertebra without spinal cord injury

  • 805.6 Closed fracture of sacrum and coccyx without spinal cord injury

  • 805.7 Open fracture of sacrum and coccyx without spinal cord injury

  • 805.8 Closed fracture of unspecified part of vertebral column without spinal cord injury

  • 805.9 Open fracture of unspecified part of vertebral column without spinal cord injury

ICD-10-CM CODES2

  • S12.9XXA Fracture of neck, unspecified, initial encounter

  • S22.009A Unspecified fracture of unspecified thoracic vertebra, initial encounter for closed fracture

  • S22.009B Unspecified fracture of unspecified thoracic vertebra, initial encounter for open fracture

  • S32.009A Unspecified fracture of unspecified lumbar vertebra, initial encounter for closed fracture

  • S32.009B Unspecified fracture of unspecified lumbar vertebra, initial encounter for open fracture

  • S32.10XA Unspecified fracture of sacrum, initial encounter for closed fracture

  • S32.2XXA Fracture of coccyx, initial encounter for closed fracture

  • S32.10XB Unspecified fracture of sacrum, initial encounter for open fracture

  • S32.2XXB Fracture of coccyx, initial encounter for open fracture

PREFERRED PRACTICE PATTERN3

  • 4G: Impaired Joint Mobility, Muscle Performance, and Range of Motion Associated with Fracture

FIGURE 143-1

Lesions of a single vertebra. (A) Spondylolisthesis. (B) Herniated intervertebral disk. (C) Stable compression vertebral fracture. (D) Unstable compression vertebral fracture. (E) Interlocking or subluxation of vertebra. (From LeBlond RF, DeGowin RL, Brown DD. DeGowin’s Diagnostic Examination. 9th ed. www.accessmedicine.com. Copyright © The McGraw-Hill Companies, Inc. All rights reserved.)

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PATIENT PRESENTATION

A 78-year-old man lost his balance and fell while ambulating at home with his four-wheeled rolling walker. He reports he hit his back on the sofa as he was falling and landed in a sitting position. He reports immediate pain with inability to stand up, so emergency services are contacted. He has a history of chronic obstructive pulmonary disease for which he has had prolonged exposure to steroids for management. He presents with increased pain with all movements and his only position of mild comfort is lying supine. Radiographs showed T12-L1 acute compression fractures. There was anterior vertebral body wedging deformity noted on the lateral view and decreased vertebral height noted on the posterior view.

KEY FEATURES

Description

  • Fracture

  • Any defect in the continuity of the end plate or vertebral body

  • Types of spinal fractures

    • Compression fracture

      • Wedge deformity

        ...

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