To evaluate the characteristics of burst fracture with distraction injury of the posterior column and provide diagnostic information categorizing thoracolumbar fractures causing instability.

Twenty-one patients with a thoracolumbar burst fracture and posterior column injury, as confirmed by radiogram or MRI were included in this study. To evaluate clinical features, the characteristics of the injury mechanism and the physical findings were reviewed. The degree of kyphotic deformity, compression ratio and canal encroachment were measured.

The group consisted of ten men and eleven women with a mean age of 39.3 years. The most common cause of injury was a fall from height in 14 cases. A superficial tenderness was noted in all cases. Of twenty-one patients, eleven had an associated spinal fracture. Kyphotic deformity, compression ratio and canal encroachment were 19.9o, 23% and 14% in an average, respectively.

Our data demonstrated that burst fracture with distraction injury of the posterior column has no remarkable radiographic parameter despite the associated significant instability. This finding suggests that the index of suspicion for this type of injury is important, and physicians should be aware of the integrity of the posterior column.