Bradley John Carra MD, Presenter: Nothing to Disclose

Liem Thanh Mansfield MD, Abstract Co-Author: Nothing to Disclose

Michael Jason Reiter DO, Abstract Co-Author: Nothing to Disclose

The three-column model of the spine is widely recognized and used to classify the stability of spinal fractures. The sternal-rib complex has been shown to provide additional stability to the thoracic spine and as such has been designated the lesser known fourth column of the thoracic spine. Disruption of the sternal-rib complex can contribute to destabilization of the spine after injury and this should be recognized during assessment of stability. The biomechanical relationship between the sternal-rib complex and thoracic spine leads to specific osseous and soft tissue injury patterns in trauma and results in sternal insufficiency fractures after multiple thoracic spine osteoporotic fractures. The anatomy and biomechanics of the thoracic cage, mechanisms of traumatic and atraumatic sternal fractures, and associated injuries will be reviewed.

1. Review concept of three-column model of spine 2. Review anatomy of biomechanics of the thoracic cage 3. Illustrate stabilization of the thoracic cage by the sternal-rib complex, the so-called fourth column of the thoracic spine 4. Review mechanisms of both traumatic and osteoporotic insufficiency fractures of the sternum with three-dimensional computer animations 5. Describe life-threatening thoracic injuries associated with traumatic thoracic cage fractures

http://abstract.rsna.org/uploads/2014/14003586/14003586_uuf4.pdf

Carra, B, Mansfield, L, Reiter, M, The Sternal-rib Complex Is the Fourth Column of the Thoracic Spine: 3D Modeling of Its Role in the Mechanism of Injury to the Chest Wall and Spine.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14003586.html