EditorialThoracolumbar Spine Fractures Clinical Presentation and the Effect of Altered Sensorium and Major InjuryMeldon, Stephen W. MD; Moettus, Laila N. MDAuthor Information From the Department of Emergency Medicine, MetroHealth Medical Center; and the Department of Surgery, Case Western Reserve University, Cleveland, Ohio. Presented in part at the Society of Academic Emergency Medicine Annual Meeting, May 1994, Washington, D.C. Address for reprints: Stephen W. Meldon, MD, Department of Emergency Medicine, Sl-203, MetroHealth Medical Center, 2500 MetroHealth Drive, Cleveland, OH 44109. The Journal of Trauma: Injury, Infection, and Critical Care: December 1995 - Volume 39 - Issue 6 - p 1110-1114 Buy Abstract A retrospective review of 145 patients with thoracic or lumbar spine fractures from blunt trauma was conducted to identify the clinical presentation of these patients. The presence of back pain or tenderness (BPT), neurologic injury, altered sensorium from head injury or alcohol intoxication, and concomitant major injury were determined. Any delayed or missed diagnoses were analyzed. One hundred eighteen (81%) patients complained of BPT on their initial presentation. The presence of BPT was significantly higher in those patients without an altered sensorium or other major injury. Of the 27 (19%) patients with a negative finding of BPT, all (100%) had an altered sensorium, concomitant major injury, or neurologic deficit. There were no asymptomatic thoracic or lumbar spine fractures in neurologically intact patients with clear sensoriums and no concomitant major injuries. These patients do not need routine thoracolumbar radiography. © Williams & Wilkins 1995. All Rights Reserved.