A 30-year-old male was involved in an automobile accident. He was at the driver's seat and did not wear a seatbelt. During admission, his primary complain was back pain.
Upon admission, palpation revealed tenderness at the thoracolumbar region. His neurologic examination was normal with no motor or sensory deficit of the lower and upper limbs. Ultrasonography was performed to exclude blunt abdominal concomitant injuries. Simple radiographic evaluation of the cervical spine, thorax and pelvis did not demonstrate associated injuries. Radiographs (Figs. 1, 2) and CT scans (Fig. 3) of the thoracolumbar spine revealed a transverse fracture at the level of T12. The CT scan further demonstrated a split of the posterior elements, progressing anteriorly into the vertebral body. Conservative treatment was decided and the patient, following an initial period of bed rest, was mobilized wearing a thoracolumbar orthosis. Appropriate antithrombotic prophylaxis with low molecular weight heparin was administered, until full ambulation was achieved. The patient was followed up with serial thoracolumbar radiographs for the first 6 weeks of ambulation and later on, in one month intervals. The thoracolumbar orthosis was applied for three months. At the 5th month follow-up, he was pain free with radiographic signs of mild vertebral kyphosis. Upon completion of treatment, he returned successfully to pre-injury levels of daily activity, without any impairment.