Reduction of Bone Retropulsed Into the Spinal Canal in Thoracolumbar Vertebral Body Compression Burst Fractures

Spine ◽  
1995 ◽  
Vol 20 (15) ◽  
pp. 1699-1703 ◽  
Author(s):  
Markku J. Vornanen ◽  
Ole M. Böstman ◽  
Pertti J. Myllynen
Keyword(s):  
Vertebral Body ◽  
Spinal Canal ◽  
Burst Fractures

scholarly journals Lesión dural asociada a fracturas de charnela toracolumbar y lumbares con compromiso del muro posterior. Relación con las variables del sistema de clasificación AOSpine. [Thecal sac injury secondary to burst fractures of the thoracolumbar and lumbar spine, and its association with the AOSpine Classification System variables].

2019 ◽  
Vol 84 (3) ◽  
pp. 216-223
Author(s):  
Guillermo Alejandro Ricciardi ◽  
Ignacio Gabriel Garfinkel ◽  
Gabriel Genaro Carrioli ◽  
Daniel Oscar Ricciardi
Keyword(s):  
Vertebral Body ◽  
Neurological Deficit ◽  
Classification System ◽  
Spinal Canal ◽  
Body Wall ◽  
Thoracolumbar Spine ◽  
Cauda Equina ◽  
Acute Angle ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures

Introducción: Las lesiones del saco dural con atrapamiento de la cauda equina entre los fragmentos óseos pueden estar asociadas con fracturas toracolumbares.Objetivo: Realizar un análisis retrospectivo de las variables clínico-radiográficas y el sistema de clasificación AOSpine y la posibilidad de lesión dural asociada en una serie de fracturas toracolumbares por estallido, tratadas en nuestro Centro.Materiales y Métodos: Estudio retrospectivo, observacional de una serie de pacientes con fracturas toracolumbares con compromiso del muro posterior operados en nuestra institución, entre enero de 2012 y diciembre de 2017.Resultados: Se incluyeron 46 pacientes, 16 casos con lesión del saco dural asociada. Las variables porcentaje de ocupación del canal, distancia interpedicular, ángulo del fragmento retropulsado y déficit neurológico asociado mostraron diferencias estadísticamentesignificativas según la comparación en función de la presencia o ausencia de lesión dural (p = 0,046, p = 0,007, p = 0,046 y p = 0,004, respectivamente).Conclusiones: Según nuestros resultados, la lesión dural traumática podría ser contemplada en la planificación del tratamiento de fracturas toracolumbares ante fragmentos voluminosos del muro posterior con ángulo agudo, compromiso severo del canal raquídeo, distancia interpedicular elevada y daño neurológico asociado, tal como se propone en la bibliografía. AbstractIntroduction: Fractures of the thoracolumbar spine can trigger thecal sac injuries due to the impingement of the cauda equina between bone fragments.Objective: To carry out a retrospective analysis of clinical and radiological variables, the AOSpine Classification System and the possibility of secondary thecal sac injury in a series of thoracolumbar burst fractures treated at our center.Materials and Methods: A retrospective, observational study of a series of patients with thoracolumbar fractures with compromise of the posterior vertebral body wall, who underwent surgery at our center between January 2012 and December 2017.Results: Forty-six patients were included, 16 of which had secondary thecal sac injury. The differences in the variables—percentage of spinal canal involvement, interpedicular distance, angle of the retropulsed fragment, neurological deficit and type C fractures—were statistically significant according to the comparison made with the presence or absence of thecal sac injury (p=0.046, p=0.007, p=0.046, p=0.004, p=0,001 respectively).Conclusions: This study suggests that traumatic thecal sac injury could be suspectedwhen managing burst fractures with prominent fragments in the posterior vertebral body wall, acute angle of the retropulsed fragment, severe compression of the spinal canal, wide interpedicular distance, neurological deficit and fracture displacement (fracturetype C according to the AOSpine Classification System).

scholarly journals Finite Element Analysis of the Indirect Reduction of Posterior Pedicle Screw Fixation for a Thoracolumbar Burst Fracture

2020 ◽  
Author(s):  
Yuanzheng Song ◽  
Wei Li ◽  
Fahao Zhu
Keyword(s):  
Intervertebral Disc ◽  
Vertebral Body ◽  
Spinal Canal ◽  
Burst Fracture ◽  
Posterior Longitudinal Ligament ◽  
Neurological Dysfunction ◽  
Indirect Reduction ◽  
Thoracolumbar Burst Fracture ◽  
Maximum Displacement ◽  
Burst Fractures

Abstract Background: Because burst fractures often involve damage to the column and posterior structures of the spine, the fracture block may invade the spinal canal and compress the spinal cord or the cauda equina, causing corresponding neurological dysfunction. When a thoracolumbar burst fracture is accompanied by the presence of bone in the spinal canal, whether posterior surgery requires spinal canal incision decompression remains controversial.Methods: Computed tomography (CT) images of the thoracolumbar spine of a 31-year-old male with an L1 burst fracture and Mimics 10.0 were used to establish a three-dimensional fracture model for simulating the indirect reduction process. The model was imported into Ansys 10.0, and a 1-10 mm displacement was loaded 10° behind the Z-axis on the upper endplate of the L1 vertebral body to simulate position reduction and open reduction. The displacement and stress changes in the intervertebral disc, fractured vertebral body and posterior longitudinal ligament were observed during reduction.Results: Under a displacement loaded 10° behind the Z-axis, the maximum stress in the vertebral body was concentrated on the upper disc of the injured vertebrae. The maximum displacement corresponded to the anterior edge of the vertebral body of the injured vertebrae, and the vertebral body height and the anterior lobes were essentially restored. When the displacement load was applied in the positive Z-axis direction, the maximum displacement corresponded to the posterior longitudinal ligament behind the injured vertebrae. Under a 6 mm load, the posterior longitudinal ligament displacement was 11.3 mm. Under an 8 mm load, this displacement significantly increased to 15.0 mm, and the vertebral stress was not concentrated on the intervertebral disc.Conclusions: The reduction of thoracolumbar burst fractures by positioning and distraction allowed the injured vertebrae to be restored to the normal height and kyphotic angle. The reduction of the posterior longitudinal ligament can move the bone block in the spinal canal into the reset space and yield good reset results.

The profile of the spinal column in subjects with lumbar developmental spinal stenosis

2021 ◽  
Vol 103-B (4) ◽  
pp. 725-733
Author(s):  
Marcus Kin Long Lai ◽  
Prudence Wing Hang Cheung ◽  
Dino Samartzis ◽  
Jaro Karppinen ◽  
Kenneth M. C. Cheung ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Spinal Stenosis ◽  
Vertebral Body ◽  
Spinal Canal ◽  
Facet Joint ◽  
Spinal Column ◽  
Stepwise Logistic Regression ◽  
Diagnostic Study ◽  
Vertebral Canal ◽  
Dural Sac

Aims The aim of this study was to determine the differences in spinal imaging characteristics between subjects with or without lumbar developmental spinal stenosis (DSS) in a population-based cohort. Methods This was a radiological analysis of 2,387 participants who underwent L1-S1 MRI. Means and ranges were calculated for age, sex, BMI, and MRI measurements. Anteroposterior (AP) vertebral canal diameters were used to differentiate those with DSS from controls. Other imaging parameters included vertebral body dimensions, spinal canal dimensions, disc degeneration scores, and facet joint orientation. Mann-Whitney U and chi-squared tests were conducted to search for measurement differences between those with DSS and controls. In order to identify possible associations between DSS and MRI parameters, those who were statistically significant in the univariate binary logistic regression were included in a multivariate stepwise logistic regression after adjusting for demographics. Odds ratios (ORs) and 95% confidence intervals (CIs) were reported where appropriate. Results Axial AP vertebral canal diameter (p < 0.001), interpedicular distance (p < 0.001), AP dural sac diameter (p < 0.001), lamina angle (p < 0.001), and sagittal mid-vertebral body height (p < 0.001) were significantly different between those identified as having DSS and controls. Narrower interpedicular distance (OR 0.745 (95% CI 0.618 to 0.900); p = 0.002) and AP dural sac diameter (OR 0.506 (95% CI 0.400 to 0.641); p < 0.001) were associated with DSS. Lamina angle (OR 1.127 (95% CI 1.045 to 1.214); p = 0.002) and right facet joint angulation (OR 0.022 (95% CI 0.002 to 0.247); p = 0.002) were also associated with DSS. No association was observed between disc parameters and DSS. Conclusion From this large-scale cohort, the canal size is found to be independent of body stature. Other than spinal canal dimensions, abnormal orientations of lamina angle and facet joint angulation may also be a result of developmental variations, leading to increased likelihood of DSS. Other skeletal parameters are spared. There was no relationship between DSS and soft tissue changes of the spinal column, which suggests that DSS is a unique result of bony maldevelopment. These findings require validation in other ethnicities and populations. Level of Evidence: I (diagnostic study) Cite this article: Bone Joint J 2021;103-B(4):725–733.

Anatomy of the Spinal Cord

2021 ◽  
pp. 60-67
Author(s):  
Jennifer A. Tracy
Keyword(s):  
Spinal Cord ◽  
Vertebral Body ◽  
Spinal Canal ◽  
Conus Medullaris ◽  
Lower Limbs ◽  
Cervical Cord ◽  
Filum Terminale ◽  
Upper Limbs ◽  
Descending Pathways ◽  
Lumbar Vertebral Body

The spinal cord begins as the cervical cord immediately below the medulla and extends through the spinal canal, where it becomes the thoracic, lumbar, sacral, and coccygeal parts of the cord. In most persons, the spinal cord proper ends at the lower portion of the first lumbar vertebral body, where it forms the conus medullaris and, finally, the filum terminale. A cervical enlargement contains the innervation pathways of the upper limbs; a lumbar enlargement contains the pathways of the lower limbs. This chapter reviews ascending and descending pathways in the spinal cord.

Cervical Spinal Canal Plasticity in Children as Determined by the Vertebral Body Ratio Technique

Spine ◽  
1990 ◽  
Vol 15 (10) ◽  
pp. 1003-1005
Author(s):  
MURRAY D. ROBINSON ◽  
BRUCE NORTHRUP ◽  
ROBERT SABO
Keyword(s):  
Vertebral Body ◽  
Spinal Canal ◽  
Cervical Spinal Canal

scholarly journals Vertebral hemangioma coincident with metastasis of colon adenocarcinoma

2016 ◽  
Vol 24 (3) ◽  
pp. 506-509 ◽  
Author(s):  
Krzysztof Zapałowicz ◽  
Grażyna Bierzyńska-Macyszyn ◽  
Bartłomiej Stasiów ◽  
Aleksandra Krzan ◽  
Beata Wierzycka ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Vertebral Body ◽  
Spinal Canal ◽  
Cancer Metastasis ◽  
Histopathological Examination ◽  
Colon Adenocarcinoma ◽  
Quadriceps Muscle ◽  
Right Hemicolectomy ◽  
Tissue Mass ◽  
Colon Cancer Metastasis

The authors report on colon cancer metastasis to the L-3 vertebra, which had been previously found to be involved by an asymptomatic hemangioma. A 61-year-old female patient was admitted after onset of lumbar axial pain and weakness of the right quadriceps muscle. Her medical history included colon cancer that had been diagnosed 3 years earlier and was treated via a right hemicolectomy followed by chemotherapy. Presurgical imaging revealed an asymptomatic hemangioma in the L-3 vertebral body. Computed tomography and MRI of the spine were performed after admission and revealed a hemangioma in the L-3 vertebral body as well as a soft-tissue mass protruding from the L-3 vertebral body to the spinal canal. Treatment consisted of vertebroplasty of the hemangioma, left L-3 hemilaminectomy, and removal of the pathological mass from the spinal canal and the L-3 vertebral body. Histopathological examination revealed the presence of colon cancer metastasis and a hemangioma in the same vertebra.

Large Vertebral Body, in Addition to Narrow Spinal Canal, Are Risk Factors for Cervical Myelopathy

1996 ◽  
Vol 9 (3) ◽  
pp. 177???186 ◽  
Author(s):  
Sinsuke Hukuda ◽  
Li Fang Xiang ◽  
Shinji Imai ◽  
Akitomo Katsuura ◽  
Tohru Imanaka
Keyword(s):  
Risk Factors ◽  
Vertebral Body ◽  
Cervical Myelopathy ◽  
Spinal Canal ◽  
Narrow Spinal Canal

scholarly journals AUTOMATIC SPINAL FRACTURE DIAGNOSIS AND SURGICAL MANAGEMENT BASED ON 3D IMAGE ANALYSIS AND RECONSTRUCTION OF CT TRANSVERSE SECTIONS

2002 ◽  
Vol 14 (05) ◽  
pp. 204-214 ◽  
Author(s):  
MING-SHIUM HSIEH ◽  
MING-DAR TSAI ◽  
YI-DER YEH ◽  
SHYAN-BIN JOU
Keyword(s):  
Image Analysis ◽  
Vertebral Body ◽  
Compression Fracture ◽  
Spinal Fracture ◽  
Prototype System ◽  
B Spline ◽  
Burst Fractures ◽  
3D Geometry ◽  
Fracture Body ◽  
Fracture Diagnosis

This paper describes an image analysis method that uses automatic algorithms for the evaluation of 3D geometry of vertebral bones and spinal anatomic curve in the diagnosis of compression and burst fractures. The method uses a radial B-spline curve to approximate the ellipse-like vertebral body on a transverse section with a concave feature to evaluate the compression of the canal, and infers the anatomic curve of a vertebral body by linearly regressing the centers of B-spline approximate ellipse-like boundaries of the transversal sections passing the vertebral body. This method, then, calculates the reduced angle and height for recovering the compression fracture by comparing the regressed centerlines of neighboring bodies of the fracture body with the normal spinal anatomic curve. The prototype system can be used as a qualitative and quantitative tool for the diagnosis of compression and burst fractures using transverse sections, and for the instruction to plan accurate surgical procedures. An example demonstrates the fractured spine can be accurately diagnosed and instructed to operate by our method that achieved anatomic stability, released the syndrome of nerve compression and bone pain.

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