Correlation between Image Findings and Neurological Deficits in Lower Lumbar Fractures

Background: Traumatic fractures of the lower lumbar spine (L3–L5) are rare, comprising ten to thirteen percent of thoracolumbar injuries. Their distinct anatomy and lordotic alignment led to unique loading patterns and a higher risk of burst fractures. Aim of Study: To evaluate the correlation between image findings and neurological deficits in lower lumbar fractures. Patients and Methods: A retrospective review of our insti-tution’s database for the period from July 2018 and July 2024 yielded 50 consecutive patients who had undergone surgery for lower lumbar fractures. There is no origin of any possible selection bias. Cases have been categorized into two groups: those with neurodeficits (ASIA A, B, C, and D) and those with normal neurology (ASIA E), and radiological predictors have been examined among both groups. Results: Among patients with neurological deficits, road traffic accidents were the predominant trauma mechanism (n=17), while falls from height were more frequent in the non-neurological group (n=12). No significant difference was found in gender distribution (p>0.05). L3 fractures (n=13), posterior ligamentous complex (PLC) injuries (n=14), and epi-dural hematomas (n=12) were significantly more often in the neurological deficit group (p<0.05). In contrast, L5 fractures were more prevalent in the non-neurological group (n=18 vs. n=2, p<0.05). Insignificant variances have been found with regard to vertical laminar fractures or overall sex distribution among the groups (p>0.05). Conclusion: Neurological deficits were linked to L3 fractures, PLC injuries, and canal compromise, while sex, trauma mechanism, and laminar fractures showed no signif-icant impact.