Condition · Spinal fractures & trauma
Chance Fracture
A Chance injury crosses the vertebra from back to front after sudden forward bending over a restraint or fulcrum — and may pass through bone, ligaments, or both.
Symptoms
Patients often have focal thoracolumbar pain after sudden forward bending over a restraint or fulcrum. Neurologic symptoms can occur, and abdominal pain or tenderness may signal an associated internal injury.
Diagnosis
Trauma evaluation includes a careful neurologic and abdominal examination. CT defines the bony fracture; MRI helps identify injury to the posterior ligaments, discs, spinal cord, and other soft tissues.
Treatment options
Selected nondisplaced, predominantly bony injuries with preserved alignment may be treated in a brace with strict follow-up. Associated injuries are managed at the same time by the appropriate trauma specialists.
When surgery is considered
Surgical stabilization is considered when ligaments are disrupted, the fracture is displaced or unstable, alignment cannot be maintained, neurologic injury is present, or bracing is unlikely to succeed.
When to seek care promptly
A Chance fracture is a trauma injury: seek emergency evaluation, and mention any seat-belt or restraint mechanism and any abdominal pain.
Initial consultation or second opinion?
Meet Dr. Jihoon Choi for an initial consultation — or bring your imaging for an independent second opinion before your next step. Call (972) 817-7450 or request a visit online.