Spinal fractures Quiz: Ace Your Exams

A 70-year-old woman presents to the emergency department after experiencing a fall. The patient slipped while walking and fell directly onto her back, hitting the hard-wood floor. The patient has low back pain that worsens with movement, and she has trouble walking secondary to the pain. She has a past medical history of hypertension and diabetes, and she takes lisinopril and metformin daily. Temperature is 37°C (98.6°F), blood pressure is 157/64 mmHg, heart rate is 82 beats per minute, respiratory rate is 17 breaths per minute, and oxygen saturation is 100% on room air. The patient endorses lower back pain. Bilateral breath sounds are present, and there is no evidence of obvious bleeding. The neurological exam is within normal limits. Examination of the back reveals point tenderness at the L4 level. The patient is unable to ambulate due to pain. Computed tomography (CT) of the lumbar spine is obtained, which demonstrates a compression deformity of the L4 vertebral body. Which of the following is the most appropriate disposition for this patient?