Thoracolumbar Chance fracture during a professional female soccer game: case report

ABSTRACT We report a rare case of an unstable flexion-distraction spine fracture with ligament involvement that occurred during a professional female soccer game. There were no neurological déficit. The patient had a painful midline gap which suggested ligamentar injury that was not immediately recognized. Despite that, proper immobilization and referral to hospital for further evaluation avoided additional spinal cord damage. The patient underwent a monosegmental posterior instrumentation spine fusion and after 6 months returned to professional soccer activities. This paper alerts to the possibility of occurrence of severe and unstable spine injuries during soccer practice and the importance of an adequate initial care at the game field in order to avoid iatrogenic neurological injuries.

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The Relevance of the Occult Cervical Spine Controversy and Mechanism of Injury to Prehospital Protocols: A Review of the Issues and Literature

Prehospital and Disaster Medicine ◽

10.1017/s1049023x00043004 ◽

1996 ◽

Vol 11 (3) ◽

pp. 228-233 ◽

Cited By ~ 11

Author(s):

Alexander M. Butman ◽

Daniel T. Schelble ◽

Richard W. Vomacka

Keyword(s):

Spinal Cord ◽

Clinical Signs ◽

Signs And Symptoms ◽

Neurological Deficits ◽

Spine Injury ◽

Mechanism Of Injury ◽

Spine Trauma ◽

Spinal Cord Damage ◽

Spinal Immobilization ◽

Spine Injuries

Prehospital guidelines that define the clinical indications for spine trauma also serve as the criteria for selective spinal immobilization in the field. Therefore, these criteria are important for avoiding further spinal cord damage. Because some spine injuries may occur without neurological deficits or other clinical signs, the recommended field guidelines extend beyond the signs and symptoms and include mechanisms of injury or other injuries commonly associated with a high risk of spine injury.

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Controversies in Managing of Thoracic-Lumbar Upper Burst Fractures

Neurologico Spinale Medico Chirurgico ◽

10.15562/nsmc.v1i2.76 ◽

2018 ◽

Vol 1 (2) ◽

Author(s):

Sahat Edison Sitorus

Keyword(s):

Decision Making ◽

Spinal Cord ◽

Posterior Instrumentation ◽

Burst Fracture ◽

Surgical Decompression ◽

Neurologic Deficit ◽

Retroperitoneal Approach ◽

Burst Fractures ◽

Lateral Fixation

Upper burst fracture of Th12-L1 has unique anatomy because it contains lower spinal cord, medullary cone, and diaphragm which separates between the thoracic and lumbar spine.The presence or absence of neurologic deficit is the single most important factor in the decision making. The presence of profound but incomplete neural deficit in association with canal compromise represents an urgent indication of surgical decompression. Antero-lateral direct decompression with trans-thoracic trans-pleural–retroperitoneal approach given the proximity the cord and conus is the most effective method, with inter-vertebral instrumentation with or without lateral fixation or posterior instrumentation.

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Operative Treatment of Severe Cervical Spine Injuries Sustained in Youth Sports: Experience from a Pediatric Level 1 Trauma Center over a 16-Year Period

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00085 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0008

Author(s):

Bram P Verhofste ◽

Daniel J Hedequist ◽

Craig M Birch ◽

Emily S Rademacher ◽

Michael P Glotzbecker ◽

...

Keyword(s):

Spinal Cord ◽

Cervical Spine ◽

Trauma Center ◽

Youth Sports ◽

Axial Loading ◽

Permanent Disability ◽

Cervical Spine Injuries ◽

Cord Injury ◽

Spine Injuries ◽

Level 1

Background: Sports-related cervical spine injuries (CSI) are devastating traumas with the potential for permanent disability. There is a paucity of literature on operative CSI sustained in youth athletes. Hypothesis/Purpose: The aims of this study aims were to review injury characteristics, surgical treatment, and outcomes of severe pediatric CSI encountered in youth sports. Methods: We reviewed children less than 18 years old with operative sports-related CSI at a pediatric Level 1 pediatric trauma center between 2004−2019. All cases underwent modern cervical spine instrumentation and fusion. SCI were stratified according to the American Spinal Injury Association Impairment Scale (ASIA). Clinical, radiographic, and surgical characteristics were compared between groups of patients with and without spinal cord injury (SCI). Results: Three thousand two hundred and thirty-one children (mean, 11.3y±4.6y) were evaluated for CSI at our institution during the 16-year period. The majority of traumas resulted from sports/recreational activities and were seen in 1365 cases (42.3%). Of these, 171/1365 patients (12.5%) were admitted and 29/1365 patients (2.1%) required surgical intervention (mean age, 14.5y±2.88y; range, 6.4y–17.8y). Sports included: eight football (28%), seven wrestling (24%), five gymnastics (17%), four diving (14%), two trampoline (7%), one hockey (3%), one snowboarding (3%), and one biking injury (3%). Mechanisms were 19 hyperflexion (65%), eight axial loading (28%), and two hyperextension injuries (7%). The majority of operative CSI were fractures (79%) and/or subaxial defects (72%). Seven patients (30%) sustained SCI and three patients (10%) spinal cord contusion or myelomalacia without neurologic deficits. The risk of SCI increased with age (15.8y vs. 14.4y; p=0.03) and axial loading mechanism (71% vs. 14%; p=0.003). Postoperatively, two SCI patients (29%) improved 1 ASIA Grade and one (14%) improved 2 ASIA Grades. Increased complications developed in SCI than patients without SCI (mean, 2.0 vs 0.1 complications; p=0.02). Clinical and radiographic fusion occurred in 24/26 patients (92%) with adequate follow-up (median, 32 months). Ten patients returned to their previous activity and nine to sports with a lower level of activity. Conclusion: The overall incidence of sports-related operative CSI is low. Age- and gender discrepancies exist, with male adolescent athletes most commonly requiring surgery. Hyperflexion injuries had a good prognosis; however, older males with axial loading CSI sustained in contact sports were at greatest risk of SCI, complications, and permanent disability. [Figure: see text][Table: see text][Table: see text]

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The effects of treatment with antibodies to transforming growth factor β1 and β2 following spinal cord damage in the adult rat

Neuroscience ◽

10.1016/j.neuroscience.2004.03.035 ◽

2004 ◽

Vol 126 (1) ◽

pp. 173-183 ◽

Cited By ~ 26

Author(s):

V.R King ◽

J.B Phillips ◽

R.A Brown ◽

J.V Priestley

Keyword(s):

Spinal Cord ◽

Growth Factor ◽

Transforming Growth Factor ◽

Transforming Growth Factor Β1 ◽

Adult Rat ◽

Spinal Cord Damage

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SPINAL-CORD DAMAGE FROM HYPEREXTENSION INJURIES IN CERVICAL SPONDYLOSIS

The Lancet ◽

10.1016/s0140-6736(63)91788-4 ◽

1963 ◽

Vol 281 (7288) ◽

pp. 1003

Author(s):

J.B. Cook

Keyword(s):

Spinal Cord ◽

Cervical Spondylosis ◽

Spinal Cord Damage

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Assessment of spinal cord damage in MS using MRI

Journal of the Neurological Sciences ◽

10.1016/s0022-510x(99)00276-2 ◽

2000 ◽

Vol 172 ◽

pp. S36-S39 ◽

Cited By ~ 10

Author(s):

Robert I. Grossman ◽

Fredrick Barkhof ◽

Massimo Filippi

Keyword(s):

Spinal Cord ◽

Spinal Cord Damage

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Spine-shortening vertebral osteotomy in a patient with tethered cord syndrome and a vertebral fracture

Journal of Neurosurgery Spine ◽

10.3171/spi/2008/9/7/062 ◽

2008 ◽

Vol 9 (1) ◽

pp. 62-66 ◽

Cited By ~ 15

Author(s):

Haruo Kanno ◽

Toshimi Aizawa ◽

Hiroshi Ozawa ◽

Takeshi Hoshikawa ◽

Eiji Itoi ◽

...

Keyword(s):

Spinal Cord ◽

Vertebral Fracture ◽

Rare Case ◽

Tethered Cord ◽

Conus Medullaris ◽

Tethered Cord Syndrome ◽

Bone Union ◽

Tethered Spinal Cord ◽

Fracture Fragment ◽

Loss Of Correction

The authors report a rare case of tethered cord syndrome with low-placed conus medullaris complicated by a vertebral fracture that was successfully treated by a spine-shortening vertebral osteotomy. The patient was a 57-year-old woman whose neurological condition worsened after a T-12 vertebral fracture because a fracture fragment and the associated local kyphotic deformity directly compressed the tethered spinal cord. An osteotomy of the T-12 vertebra was performed in order to correct the kyphosis, remove the fracture fragment, and reduce the tension on the spinal cord. Postoperative radiographs showed the spine to be shortened by 22 mm, and the kyphosis between T-11 and L-1 improved from 23° to 0°. Two years after the surgery, the patient's neurological symptoms were resolved. The bone union was complete with no loss of correction.

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NONCOMPLICATED UNSTABLE SPINE INJURIES IN CHILDREN

Hirurgiâ pozvonočnika ◽

10.14531/ss2005.2.8-12 ◽

2005 ◽

pp. 008-012 ◽

Cited By ~ 1

Author(s):

Eduard Vladimirovich Ulrikh ◽

Sergey Valentinivich Vissarionov ◽

Aleksandr Yuryevich Mushkin

Keyword(s):

Surgical Treatment ◽

Posterior Instrumentation ◽

Spinal Injuries ◽

Anterior Decompression ◽

Two Stage ◽

Spinal Stabilization ◽

Spine Injuries ◽

Group A ◽

Bone Autograft

Thirty-four patients aged from 3 to 17 years were operated on for noncomplicated unstable injuries of the spine. The operation was performed within the next few hours or days after trauma in 15 cases and significantly later (in 2 to 6 months) in 19 cases. In the first group the surgery included indirect posterior instrumental reduction and stabilization of the spine. In the second group a two-stage surgery was performed simultaneously. The first stage included anterior decompression and stabilization, and the second – posterior instrumentation. In both groups the posterior fusion with bone autograft was done. The post-op follow-up was 5 years. The correction of deformity, spinal stabilization and pain arrest were achieved in all cases. The surgical treatment of unstable noncomplicated spinal injuries in children must be conducted by emergency indications within the first hours and days after trauma.

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