A 35-year-old man sustains a flexion injury in a road traffic accident. Imaging shows disruption of the posterior ligamentous complex. Which ligament is the FIRST to fail in a flexion-distraction injury of the thoracolumbar spine?
- A Ligamentum flavum and interspinous ligaments ✓
- B Posterior longitudinal ligament
- C Anterior longitudinal ligament
- D Supraspinous ligament
Correct answer: A. Ligamentum flavum and interspinous ligaments
Explanation
In a flexion-distraction injury (Chance fracture), the posterior ligamentous complex fails first, typically involving the supraspinous ligament, interspinous ligaments, and ligamentum flavum. The facet joints may also be disrupted. The anterior longitudinal ligament often remains intact, acting as a hinge. The posterior longitudinal ligament is in the spinal canal and is not part of the posterior tension band that fails first in this mechanism.
Reference: Rockwood and Green's Fractures in Adults, 9th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.