Indications
Indications of L4 and L5 and lumbar fractures in general,consist of having the primary complaint of moderate to severe low back pain, which worsens with movement. If compression of the spinal column is present, then the patient could have cauda equina symptons with complaints of numbness, tingling, weakness, or problems with bowel and bladder. With high trauma impacts, patients cans also experience other assoiciated symptons due to head trauma or lost of consciousness.1
Incidence/Prevalence
These type of fractures to the lumbar spine are not common and are caused by trauma such as motor vehicle accidents and falls. Men and the elderly populations are more likely to suffer from lumbar fractures.1 Individuals with pathologies such as osteoporosis and tumors that result in weakened bone structure are more susceptible to fractures of the vertebral column. 1 Fractures of the L4 and L5 lumbar vertebrae resulting in neurological or major biomechanical instability is extremely low and is least likey to occur. 2 Osteoporosis accounts for the majority of lumbar compression fractures.3 Osteoporotic wedge compression fractures account for fractures in 75% of women over the age of 65 with scoliosis.3
Clinical Presentation
With the presence of L4 and L5 fractures, the patient's primary complaint will be low back pain that worsens with movement. If the fracture has compressed the spinal nerve root, then the patient could have radiating symptons such as numbness and tingling, into the lower extemeties. Patients with lumbar compression fractures usually present with kyphotic posture that is unlikely to be corrected, hip flexor contractures, and moderate pain at the level of the fracture