L1 is the first lumbar vertebra at the thoracolumbar junction, a common site for burst fractures from axial compression, and the level of the conus medullaris (end of the spinal cord) in most adults.
L1 is the most common single vertebra to fracture in the entire spine, sitting at the thoracolumbar junction where biomechanical stress concentrates. Burst fractures at L1 from axial loading (fall from height) can retropulse bone fragments into the conus medullaris at this level, producing conus medullaris syndrome with a mixture of upper and lower motor neurone signs. The conus medullaris ends at L1-L2 in adults.
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