Orthopedic Injuries Around the NFL: Tony Romo's Lumbar Spine Compression Fracture

During a preseason exhibition game of this NFL season, Dallas Cowboys quarterback Tony Romo suffered a compression fracutre of his lumbar spine against the Seattle Seahawks. While this was not a season-ending injury for Romo, the veteran quarterback lost his starting position to the exceptional play of rookie quarterback Dak Prescott during his abscence.

Compression (Wedge) Fracutre:

  • Mostly in thoracic and lumbar spine
  • Mechanism: Falls, Flexion-Distraction Injury, Malignancy, Osteoporosis
  • Mostly stable unless loss of >50% of height
  • Treatment: Mostly supportive care



Chance Fracture (Not a Football Injury):

  • Mechanism: Flexion-Distraction injury, Lap-Belt injury
  • Commonly occurs at T10-L2 levels
  • Compression fracture of the anterior spine with transverse fracture through posterior elements of vertebra and posterior vertebral body
  • Three of the "columns" have a fracture
  1. Anterior: Anterior half of vertebral body and anterior longitudinal ligament
  2. Middle: Posterior half of vertebral body and posterior longitudinal ligament
  3. Posterior: Pedicles, facets, lamina, spinous/transverse processes
  • If all 3 columns are fractured: Unstable fracture
  • Keep in mind to look for intraabdominal injury
  • Treatment: TLSO, Orthopedics consult

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