What is a defining feature of a burst fracture of the spine?

A burst fracture is characterized by the involvement of all three spinal columns: anterior, middle, and posterior. This type of fracture occurs when significant axial load is applied to the spine, leading to the vertebra shattering in multiple directions.

In a burst fracture, the high-energy impact causes the vertebral body to compress and fragment, affecting the anterior and middle columns, while also potentially impacting the posterior column depending on the severity of the injury. The key defining feature is thus the involvement of both the anterior and middle columns, emphasizing that the fracture is not limited to just one segment of the spinal structure.

The specific mention of middle column compression in this context highlights the important aspect that, in burst fractures, the intervertebral disc and posterior elements are also at risk due to the nature of the injury, which typically creates instability in the entire spine segment involved.