scholarly journals Is a Fracture of the Transverse Process of L5 an Indicator of the Presence and/or Severity of a Pelvic Fracture?

2019 ◽  
Vol 3 (4) ◽  
pp. 342-347 ◽  
Author(s):  
Tadatsugu Morimoto ◽  
Motoki Sonohata ◽  
Hirohito Hirata ◽  
Makoto Shiraki ◽  
Ko Ikuta ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Transverse Process

Fractures of the transverse processes of the fourth and fifth lumbar vertebrae in patients with pelvic ring injuries

2018 ◽  
Vol 100-B (9) ◽  
pp. 1214-1219 ◽  
Author(s):  
M. Winkelmann ◽  
M. Lopez Izquierdo ◽  
J-D. Clausen ◽  
E. Liodakis ◽  
P. Mommsen ◽  
...  
Keyword(s):  
Pelvic Fracture ◽  
Pelvic Ring ◽  
Lumbar Vertebrae ◽  
Transverse Process ◽  
Trauma Centre ◽  
Pelvic Injury ◽  
Matched Pair ◽  
Haemodynamic Instability ◽  
Pelvic Ring Injury ◽  
Pelvic Ring Injuries

Aims This study aimed to analyze the correlation between transverse process (TP) fractures of the fourth (L4) and fifth (L5) lumbar vertebrae and biomechanical and haemodynamic stability in patients with a pelvic ring injury, since previous data are inconsistent. Patients and Methods The study is a retrospective matched-pair analysis of patients with a pelvic fracture according to the modified Tile AO Müller and the Young and Burgess classification who presented to a level 1 trauma centre between January 2005 and December 2014. Results A total of 728 patients with pelvic ring injuries were included, of whom 183 (25.1%) had a biomechanically unstable pelvic fracture. Of these patients, 84 (45.9%) had a fracture of a TP of L4 and/or L5. A total of 73 patients (13.4%) with a stable pelvic ring injury (p < 0.001) had a fracture of a TP. Patients with a fracture of a TP of L4 and/or L5 had a 5.5-fold risk (odds ratio (OR)) of having a biomechanically unstable pelvic injury. TP fractures (OR 1.6, p = 0.2) could not be confirmed as an independent predictor of haemodynamic instability. Conclusion This is the first study that has demonstrated a positive correlation between a TP fracture of L4 and/or L5 and a biomechanically unstable pelvic ring injury. The presence of transverse process fractures of L4 and/or L5 indicates increased severity of pelvic injury and therefore can help in the planning of emergency treatment. Cite this article: Bone Joint J 2018;100-B:1214–19.

scholarly journals A fracture of the transverse process of L5 is a predictor of pelvic fracture instability

Injury Extra ◽  
2011 ◽  
Vol 42 (9) ◽  
pp. 153
Author(s):  
I. Starks ◽  
A. Frost ◽  
P. Wall ◽  
J. Lim
Keyword(s):  
Pelvic Fracture ◽  
Transverse Process ◽  
Fracture Instability

112: Pelvic Fracture Urethral Distraction Defect Perineal Anastomotic Repair: 20-Year Experience

2007 ◽  
Vol 177 (4S) ◽  
pp. 39-39
Author(s):  
Ramon Virasoro ◽  
Michael B. Williams ◽  
Jennifer L. Bepple ◽  
Jessica Drummond ◽  
Gerald H. Jordan
Keyword(s):  
Pelvic Fracture

330: Sexual and Excretory Dysfunction One Year after Pelvic Fracture

2005 ◽  
Vol 173 (4S) ◽  
pp. 91-91
Author(s):  
Jonathan L. Wright ◽  
Hunter B. Wessells ◽  
Avery B. Nathens ◽  
Ellen MacKenzie ◽  
Frederick P. Rivara
Keyword(s):  
Pelvic Fracture ◽  
One Year

Association between lumbar sacralization and increased degree of vertebral slippage and disc degeneration in patients with L4 spondylolysis

2019 ◽  
Vol 30 (6) ◽  
pp. 767-771
Author(s):  
Xinqiang Yao ◽  
Ruoting Ding ◽  
Junhao Liu ◽  
Siyuan Zhu ◽  
Jingshen Zhuang ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Disc Degeneration ◽  
Transverse Process ◽  
Modic Changes ◽  
Bony Fusion ◽  
Transitional Vertebra ◽  
Type Iiia ◽  
Type Iiib ◽  
Significant Difference ◽  
Lumbosacral Transitional Vertebra

OBJECTIVEThe aim of this study was to evaluate the effect of lumbar sacralization on the level of vertebral slip and disc degeneration in patients with L4 spondylolysis.METHODSThe authors analyzed data from 102 cases in which patients underwent surgical treatment for L4 spondylolysis and spondylolisthesis at their institution between March 2007 and September 2016. Lumbar sacralization was characterized by the presence of pseudarthrosis and/or bony fusion between the L5 transverse process and sacrum, and the type of lumbosacral transitional vertebra (LSTV) was evaluated with the Castellvi classification. The amount of vertebral slippage was measured using the Taillard technique and Meyerding grade. Degeneration of the L4–5 segment was quantified using the Pfirrmann and Modic classifications. Patients were divided into 2 groups based on the presence or absence of sacralization, and the amount of vertebral slip and degeneration of the L4–5 segment was compared between groups.RESULTSLumbar sacralization was present in 37 (36%) of 102 patients with L4 spondylolysis. The LSTV was type IIa in 10 cases, type IIb in 7, type IIIa in 2, and type IIIb in 18. The levels of vertebral slip and disc degeneration in the group of patients with sacralization were significantly greater than in the group without sacralization. No significant difference was found between the 2 groups with respect to Modic changes.CONCLUSIONSThe increased stability between a sacralized L5 and the sacrum may predispose the L4–5 segment to greater instability and disc degeneration in patients with L4 spondylolysis.

scholarly journals Effective erector spinae plane block for postoperative analgesia in a pyothorax patient who underwent emergency re-open thoracotomy—a case report

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Izumi Kawagoe ◽  
Daizoh Satoh ◽  
Mariko Fukui ◽  
Kenji Suzuki ◽  
Eiichi Inada
Keyword(s):  
Postoperative Analgesia ◽  
Transverse Process ◽  
Erector Spinae ◽  
Open Thoracotomy ◽  
Case Presentation ◽  
Lung Lobectomy ◽  
Erector Spinae Plane Block ◽  
Lower Lung ◽  
The Right ◽  
Vein Stenosis

Abstract Background The appropriate choice of postoperative analgesia for pyothorax surgery is unclear since local infection could contaminate the catheter used for regional blocks and bacteremia can lead to disordered coagulation. We performed erector spinae plane block (ESPB) in a pyothorax patient undergoing emergency re-open thoracotomy. Case presentation An 81-year-old male with internal jugular vein stenosis on aspirin therapy was scheduled for pyothorax drainage and residual middle lobectomy 14 days after he underwent open right lower lung lobectomy for lung cancer. ESPB was performed with injection of 20 ml of 0.375% levobupivacaine at the Th5 transverse process of the right side under ultrasound guidance. Although he needed intravenous pentazocine for pain on postoperative day 0, no more analgesics were required postoperatively. NRS score ranged from 0 to 1 thereafter. Conclusions ESPB provided effective postoperative analgesia following emergency re-open thoracotomy for our pyothorax patient. ESPB might be the appropriate choice for postoperative analgesia following pyothorax surgery.

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