Surgical management of lower limb fractures in patients with spinal cord injury less associated with complications than non-operative management: A retrospective series of cases

Abstract Background According to most of the commonly used classification systems for subaxial spine injuries, unilateral and minimally displaced facet fractures without any sign of a spinal cord injury would be directed to non-operative management. However, the failure rate of non-operative treatment varies from 20 to 80%, and no consensus exists with regard to predictors of failure after non-operative management. Case presentation Case 1 is a patient with a unilateral facet fracture. The patient had only numbness in the right C6 dermatome but failed non-operative treatment, which resulted in severe spinal cord injury. Case 2 is a patient who had a similar injury pattern as case 1 but presented with immediate instability and underwent fusion surgery. Both patients had a minimally displaced unilateral facet fracture accompanied by disc injury and blunt vertebral artery injury, which are possible signs indicating significant instability. Conclusions This is the first report of an isolated unilateral facet fracture that resulted in catastrophic spinal cord injury. These two cases illustrate that an isolated minimally displaced unilateral facet fracture with disc injury and vertebral artery injury were associated with significant instability that can lead to spinal cord injury.

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Management of acute spinal cord injury: A summary of the evidence pertaining to the acute management, operative and non-operative management

World Journal of Orthopedics ◽

10.5312/wjo.v11.i12.573 ◽

2020 ◽

Vol 11 (12) ◽

pp. 573-583

Author(s):

Darren Sandean

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Operative Management ◽

Acute Spinal Cord Injury ◽

Acute Management ◽

Cord Injury ◽

Non Operative Management

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Faculty Opinions recommendation of Medical and surgical management after spinal cord injury: vasopressor usage, early surgerys, and complications.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.718105982.793555971 ◽

2019 ◽

Author(s):

Gregory Hawryluk

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Surgical Management ◽

Cord Injury

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Improving sit-to-stand transition by the saddle-assistive device in the spinal cord injury: A case study

Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine ◽

10.1177/09544119211003370 ◽

2021 ◽

pp. 095441192110033

Author(s):

Akbar Hojjati Najafabadi ◽

Saeid Amini ◽

Farzam Farahmand

Keyword(s):

Spinal Cord ◽

Spinal Cord Injury ◽

Lower Limb ◽

Reaction Force ◽

Assistive Device ◽

Limb Weakness ◽

Sit To Stand ◽

Lower Limb Weakness ◽

Wide Range ◽

Cord Injury

Physical problems caused by fractures, aging, stroke, and accidents can reduce foot power; these, in the long term, can dwindle the muscles of the waist, thighs, and legs. These conditions provide the basis for the invalidism of the harmed people. In this study, a saddle-walker was designed and evaluated to help people suffering from spinal cord injury and patients with lower limb weakness. This S-AD works based on body weight support against the previously report designs. This saddle-walker consisted of a non-powered four-wheel walker helping to walk and a powered mechanism for the sit-to-stand (STS) transfer. A set of experiments were done on the STS in the use of the standard walker and the saddle-assistive device(S-AD). A comparison of the results showed that this device could reduce the vertical ground reaction force (GRF) of the legs up to 70%. Using this device could help a wide range of patients with lower limb weakness and SCI patients in changing from sitting to standing.

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