scholarly journals Posterior approach for cervical fracture–dislocations with traumatic disc herniation

2010 ◽  
Vol 20 (3) ◽  
pp. 387-394 ◽  
Author(s):  
Hiroaki Nakashima ◽  
Yasutsugu Yukawa ◽  
Keigo Ito ◽  
Masaaki Machino ◽  
Hany El Zahlawy ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Posterior Approach ◽  
Cervical Fracture ◽  
Fracture Dislocations

scholarly journals The posterior approach operation to treat thoracolumbar disc herniation

Medicine ◽  
2018 ◽  
Vol 97 (16) ◽  
pp. e0458 ◽  
Author(s):  
Jian Kang ◽  
ZhengQi Chang ◽  
Weimin Huang ◽  
Xiuchun Yu
Keyword(s):  
Disc Herniation ◽  
Posterior Approach

Cervical Fracture Dislocation

2018 ◽  
pp. 11-20
Author(s):  
Jason Liounakos ◽  
G. Damian Brusko ◽  
Michael Y. Wang
Keyword(s):  
Disc Herniation ◽  
Closed Reduction ◽  
High Energy ◽  
Cord Compression ◽  
Accurate Diagnosis ◽  
Fracture Dislocation ◽  
Cervical Fracture ◽  
Neurogenic Shock ◽  
Cervical Spine Fractures ◽  
Case Basis

Cervical spine fractures resulting in a dislocation often occur with a high-energy trauma. Prompt and accurate diagnosis of a fracture can be obtained with a CT scan. Controversy exists as to whether closed reduction should be performed prior to obtaining an MRI due to concerns of traumatic disc herniation. Closed reduction of a fracture with a traumatic disc herniation can potentially worsen a neurologic deficit by creating more severe cord compression. Open or closed reduction of a cervical fracture should be followed by internal fixation. Anterior, posterior, or circumferential fixation should be instituted on a case-by-case basis. Postoperative care in an intensive care unit includes maintaining adequate mean arterial pressure for spinal cord perfusion, and monitoring for signs of neurogenic shock.

scholarly journals Treatment of subacute thoracic spine fracture-dislocation by total vertebrectomy and spine shortening

2013 ◽  
Vol 18 (2) ◽  
pp. 194-200 ◽  
Author(s):  
Alecio C. E. S. Barcelos ◽  
Ricardo V. Botelho
Keyword(s):  
Posterior Approach ◽  
Posterior Instrumentation ◽  
Complete Recovery ◽  
Current Treatment ◽  
Fracture Dislocation ◽  
Fracture Dislocations ◽  
Thoracic Spine Fracture ◽  
Surgical Teams ◽  
Anterior Support ◽  
Vertebral Resection

Vertebral resection with spine shortening has been primarily reported for the treatment of demanding cases of nontraumatic disorders. Recently, this technique has been applied to the treatment of traumatic disorders. The current treatment of vertebral fracture-dislocation when there is partial or total telescoping of the involved vertebrae is a combined anterior-posterior approach with corpectomy, anterior support implant, and further posterior instrumentation. These procedures usually require 2 surgical teams, involve longer operating times and greater risk of surgical complications related to the anterior approach, and commonly entail longer postoperative care before discharge. The authors report on 2 patients with high thoracic fracture-dislocations with telescoping (T-2 and T-4) who were treated in the subacute phase with total spondylectomy (T-3 and T-5, respectively) and spine shortening by using only a posterior approach. Complete recovery of the sagittal balance was achieved with this technique and the postoperative periods were clinically uneventful. One patient presented with asymptomatic hemothorax that did not require drainage. In paraplegic patients with anterior thoracic dislocation fractures in which one vertebral body blocks the reduction of the other, total spondylectomy and spine shortening seem to be a reasonably safe and effective technique.

scholarly journals A single-stage posterior approach with open reduction and pedicle screw fixation in subaxial cervical facet dislocations

2015 ◽  
Vol 23 (1) ◽  
pp. 35-41 ◽  
Author(s):  
Jin Hoon Park ◽  
Sung Woo Roh ◽  
Seung Chul Rhim
Keyword(s):  
Pedicle Screw ◽  
Disc Herniation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Posterior Approach ◽  
Screw Fixation ◽  
Pedicle Screw Fixation ◽  
Herniated Disc ◽  
The Mean ◽  
Cervical Facet

OBJECT The optimal treatment for cervical facet dislocations is controversial, but the generally accepted process recommends an initial closed reduction with the next step determined according to the success of the closed reduction and the presence of traumatic disc herniation. This study aimed to show the efficacy of a posterior approach performed with an open reduction and pedicle screw fixation with removal of disc particles, if required, in the management of subaxial cervical dislocations. METHODS Between March 2012 and September 2013, 21 consecutive patients with cervical facet dislocations were enrolled. The affected levels were as follows: 4 at C3–4; 2 at C4–5; 5 at C5–6; and 10 at the C6–7 level. Seven patients had traumatic disc herniations. Closed reduction was not attempted; a prompt posterior cervical surgery was performed instead. After open reduction, pedicle screw fixation was performed. In cases with traumatic disc herniation, herniated disc fragments were excised via a posterolateral approach and successful decompressions were determined by postoperative MRI studies. Clinical outcomes were assessed using the American Spinal Injury Association (ASIA) grading system. Radiological outcomes were assessed by comparing the degree of subluxation and the angle of segmental lordosis between pre- and postoperative CT scans. RESULTS All patients improved neurologically. The mean segmental angles improved from 7.3° ± 8.68° to −5.9° ± 4.85°. The mean subluxation improved from 23.4% ± 16.52% to 2.6% ± 7.19%. Disc fragments were successfully removed from the 7 patients with herniated discs, as shown on MRI. CONCLUSIONS Open reduction followed by pedicle screw fixation or posterolateral removal of herniated disc fragments is a good treatment option for cervical facet dislocations.

P123. Clinical outcome of anterior only approach for cervical fracture dislocations

2019 ◽  
Vol 19 (9) ◽  
pp. S214-S215
Author(s):  
Kaustubh Ahuja ◽  
Pankaj Kandwal ◽  
Siddharth Sekhar
Keyword(s):  
Clinical Outcome ◽  
Cervical Fracture ◽  
Fracture Dislocations

scholarly journals THORACIC DISC HERNIATION: SURGICAL DECOMPRESSION BY POSTERIOR APPROACH A LA CARTE

2016 ◽  
Vol 15 (3) ◽  
pp. 213-218 ◽  
Author(s):  
MURILO TAVARES DAHER ◽  
PEDRO FELISBINO JUNIOR ◽  
ADRIANO PASSÁGLIA ESPERIDIÃO ◽  
BRENDA CRISTINA RIBEIRO ARAÚJO ◽  
ANDRÉ LUIZ PASSOS CARDOSO ◽  
...  
Keyword(s):  
Disc Herniation ◽  
Posterior Approach ◽  
Surgical Decompression ◽  
Thoracic Disc Herniation ◽  
Transpedicular Approach ◽  
Partial Body ◽  
The Mean ◽  
Thoracic Disc ◽  
A La Carte

ABSTRACT Objectives: To present the clinical and radiographic results of patients with thoracic disc herniation treated by the posterior approach, according to location and type of hernia (à la carte). Methods: We evaluated thirteen patients (14 hernias) treated by the posterior approach. Eight (61.5%) patients were male and the mean age was 53 years (34-81). Clinical evaluation was performed by the Frankel and JOA modified scales. All the patients underwent the posterior approach, which was performed by facetectomy, transpedicular approach, transpedicular + partial body resection, costotransversectomy or costotransversectomy + reconstruction with CAGE. Results: The mean follow-up was 2 years and 6 months (11-77 months). Of the 14 operated hernias, six (43%) were lateral, 2 (14%) paramedian, and 6 (43%) central. Seven were soft (50%) and seven were calcified. The transfacet approach was carried out in 5 cases (36%), transpedicular in 1 case (7%), transpedicular + partial body resection in 4 (29%), costotransversectomy in 3 (21%), and costotransversectomy + CAGE in one case (7%). The majority of patients with lateral hernia (5/6) were subjected to transfacet decompression and in cases of central and paramedian hernias, all patients underwent decompression, which is more extensive. Conclusions: The posterior approach is safe and effective, and the best approach must be chosen based on location and type of the herniation and the surgeon's experience.

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