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Thoracolumbar burst fracture with cauda equina features — RCPSC EM MCQ

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HardTraumaThoracolumbar burst fracture with cauda equina featuresRCPSC EM

A 51-year-old man falls from a ladder and lands on his feet. He has severe back pain, decreased perianal sensation, urinary retention, and bilateral plantarflexion weakness. CT shows an L1 burst fracture with canal compromise. What is the most likely diagnosis?

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Correct answer: E — Conus medullaris or cauda equina compression from burst fracture

Urinary retention, saddle sensory loss and bilateral neurological deficits after burst fracture indicate compressive conus/cauda equina injury requiring urgent spine consultation.

Reference: Royal College Emergency Medicine exam format and training experiences