Impaction fracture of the lumbar vertebrae with dural tear

1980 ◽  
Vol 53 (6) ◽  
pp. 765-771 ◽  
Author(s):  
Carole A. Miller ◽  
Richard C. Dewey ◽  
William E. Hunt
Keyword(s):  
Lumbar Spine ◽  
Cauda Equina ◽  
Lumbar Vertebrae ◽  
Dural Tear ◽  
Mechanism Of Injury ◽  
Content Type ◽  
X Ray ◽  
Jefferson Fracture ◽  
Vertical Impaction ◽  
Fine Print

✓ The authors describe a lumbar spine fracture that is characterized on anteroposterior x-ray views by separation of the pedicular shadows. It is almost invariably associated with posterior interlaminar herniation of the cauda equina through a dorsal dural split, and anterolateral entrapment or amputation of the nerve root. The fracture is unstable and requires internal fixation and fusion at the time of neurolysis. Fractures meeting these criteria should be explored as soon as the patient's condition permits. Myelography is usually unnecessary and may be contraindicated in some cases. The postulated mechanism of injury is hyperextension with vertical impaction and rupture of the ring made up of the lamina, pedicle, and vertebral body. The ring is fractured in several places in a manner similar to that seen in “Jefferson fracture” of C-1. The special anatomical relationships of the thoracolumbar junction and the plane of the lumbar facets are also discussed.

Evaluation and treatment of atlas burst fractures (Jefferson fractures)

1991 ◽  
Vol 75 (2) ◽  
pp. 213-220 ◽  
Author(s):  
Lee Kesterson ◽  
Edward Benzel ◽  
William Orrison ◽  
James Coleman
Keyword(s):  
State University ◽  
Content Type ◽  
X Ray ◽  
Jefferson Fracture ◽  
Louisiana State University ◽  
Burst Fractures ◽  
Long Term Result ◽  
Atlas Fractures ◽  
Fine Print

✓ Although several large series of atlas fractures have been reported recently, none has concentrated on the evaluation and treatment of atlas burst fractures (Jefferson fractures). The treatment of this fracture is challenging. Its diagnosis may easily be missed due to concerns about associated trauma and absence of neurological signs. In addition, the open-mouth anteroposterior x-ray study, which is usually pathognomonic for the diagnosis, is often inadequate or not obtained. In order to clarify the diagnosis and treatment of this disorder, 17 cases of Jefferson fracture treated between 1982 and 1989 at the Louisiana State University Affiliated Hospitals are presented. The diagnosis was delayed in three patients because of a low index of suspicion and inadequate x-ray films. Four patients were noted to have unstable Jefferson fractures; all of these had an associated Type II odontoid fracture and were treated with occiput-C-2 wiring and fusion. The remainder of the patients had stable Jefferson fractures and were managed with Minerva jackets or rigid collar stabilization. No significant complications related to the treatment of the Jefferson fracture occurred in this series. One patient died from associated injuries: however, the remaining patients enjoyed an excellent long-term result with the acquisition of spinal stability and the resolution of subjective complaints.

Ependymomas

1970 ◽  
Vol 33 (4) ◽  
pp. 428-438 ◽  
Author(s):  
Bartolo M. Barone ◽  
Arthur R. Elvidge
Keyword(s):  
Fourth Ventricle ◽  
Malignant Tumors ◽  
Cauda Equina ◽  
Vital Statistics ◽  
Tumor Characteristics ◽  
Intracranial Tumors ◽  
Content Type ◽  
X Ray ◽  
Fine Print

✓ A clinical and pathological survey of 74 histologically verified ependymomas (47 intracranial, 27 spinal) was derived from a total series of 2186 gliomas. Patient ages ranged from 7 months to 64 years. The malignant tumors above the tentorium tended to occur in patients over 22 years. The greatest frequency occurred with 24 tumors in the fourth ventricle and 20 in the region of the cauda equina. The location, symptomatology, objective findings, surgical and x-ray therapy, and vital statistics have been evaluated. There was no correlation between tumor characteristics and preoperative symptomatology. Supplementary x-ray therapy appeared to be beneficial. Seventeen of the 36 patients with benign intracranial tumors and five of the 11 patients with malignant intracranial tumors survive. Fourteen of the 27 patients with spinal ependymomas survive. There was one instance of generalized metastasis in the spinal series and none in the intracranial group.

Posterior epidural migration of sequestered lumbar disc fragments

1999 ◽  
Vol 90 (2) ◽  
pp. 264-266 ◽  
Author(s):  
Pierre Robe ◽  
Didier Martin ◽  
Jacques Lenelle ◽  
Achille Stevenaert
Keyword(s):  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Contrast Material ◽  
Cauda Equina ◽  
Radicular Pain ◽  
Content Type ◽  
Diagnostic Pitfalls ◽  
Fine Print

✓ The posterior epidural migration of sequestered lumbar disc fragments is an uncommon event. The authors report two such cases in which patients presented with either intense radicular pain or cauda equina syndrome. The radiological characteristics were the posterior epidural location and the ring enhancement of the mass after injection of contrast material. The major diagnostic pitfalls are discussed.

Chondroblastoma of the lumbar spine

2005 ◽  
Vol 2 (5) ◽  
pp. 596-600 ◽  
Author(s):  
Raphaël Vialle ◽  
Antoine Feydy ◽  
Ludovic Rillardon ◽  
Carla Tohme-Noun ◽  
Philippe Anract ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Local Recurrence ◽  
Osteolytic Lesion ◽  
Radicular Pain ◽  
Appendicular Skeleton ◽  
Lumbar Region ◽  
Content Type ◽  
Anterior Posterior ◽  
Fine Print

✓ Chondroblastoma is a benign cartilaginous neoplasm that generally affects the appendicular skeleton. Twenty-six cases of spinal chondroblastoma have been reported in the past 50 years, only six of which were located in the lumbar region. The authors report two cases involving this exceptional location. In both patients, low-back pain, in the absence of radicular pain, was the presenting symptom. In both cases, plain radiography and computerized tomography scanning revealed an osteolytic lesion surrounded by marginal sclerosis. Magnetic resonance imaging allowed the authors to study the tumor's local extension. Examination of a percutaneous fluoroscopy-guided biopsy sample revealed the following typical histological features of chondroblastoma: chondroid tissue, focally alternating with cellular areas, and no nuclear atypia or pleomorphism. To reduce the risk of local recurrence, vertebrectomy and anterior—posterior fusion were performed in both cases. In one case, a structural lumbar scoliosis was corrected during the posterior procedure. There was no postoperative complication. No recurrence was observed during the 3- to 6-year follow-up period. The surgery-related results were deemed successful. Although exceptional, the diagnosis of chondroblastoma is possible in lesions involving the lumbar spine. Other spinal locations are described in the literature, and frequency of recurrence is stressed. A vertebrectomy is advised to reduce the risk of local recurrence.

Beta—tricalcium phosphate as a substitute for autograft in interbody fusion cages in the canine lumbar spine

2002 ◽  
Vol 97 (3) ◽  
pp. 350-354 ◽  
Author(s):  
Takashiro Ohyama ◽  
Yoshichika Kubo ◽  
Hiroo Iwata ◽  
Waro Taki
Keyword(s):  
Lumbar Spine ◽  
Tricalcium Phosphate ◽  
Interbody Fusion ◽  
Donor Site ◽  
Posterolateral Approach ◽  
Content Type ◽  
Spine Model ◽  
Group A ◽  
Group B ◽  
Fine Print

Object. An interbody fusion cage has been introduced for cervical anterior interbody fusion. Autogenetic bone is packed into the cage to increase the rate of union between adjacent vertebral bodies. Thus, donor site—related complications can still occur. In this study a synthetic ceramic, β—tricalcium phosphate (TCP), was examined as a substitute for autograft bone in a canine lumbar spine model. Methods. In 12 dogs L-1 to L-4 vertebrae were exposed via a posterolateral approach, and discectomy and placement of interbody fusion cages were performed at two intervertebral disc spaces. One cage was filled with autograft (Group A) and the other with TCP (Group B). The lumbar spine was excised at 16 weeks postsurgery, and biomechanical, microradiographic, and histological examinations were performed. Both the microradiographic and histological examinations revealed that fusion occurred in five (41.7%) of 12 operations performed in Group A and in six (50%) of 12 operations performed in Group B. The mean percentage of trabecular bone area in the cages was 54.6% in Group A and 53.8% in Group B. There were no significant intergroup differences in functional unit stiffness. Conclusions. Good histological and biomechanical results were obtained for TCP-filled interbody fusion cages. The results were comparable with those obtained using autograft-filled cages, suggesting that there is no need to harvest iliac bone or to use allo- or xenografts to increase the interlocking strength between the cage and vertebral bone to achieve anterior cervical interbody fusion.

Anterior sacral meningocele contiguous with a pelvic hamartoma

1984 ◽  
Vol 61 (1) ◽  
pp. 188-190 ◽  
Author(s):  
Eugene Leibowitz ◽  
William Barton ◽  
Parvis Sadighi ◽  
Jeffrey S. Ross
Keyword(s):  
Computerized Tomography ◽  
Content Type ◽  
Transabdominal Approach ◽  
X Ray ◽  
Anterior Sacral Meningocele ◽  
Fine Print

✓ A patient with an anterior sacral meningocele combined with a hamartoma was diagnosed with x-ray films, myelography, and computerized tomography. She was successfully operated on by a transabdominal approach.

Dermoid tumors of the spinal cord

1970 ◽  
Vol 33 (6) ◽  
pp. 676-681 ◽  
Author(s):  
Ian C. Bailey
Keyword(s):  
Spinal Cord ◽  
Low Back Pain ◽  
Back Pain ◽  
Cauda Equina ◽  
Complete Removal ◽  
Cord Compression ◽  
Conus Medullaris ◽  
Low Back ◽  
Content Type ◽  
Fine Print

✓ This is an analysis of 10 cases of dermoid tumor occurring in the spinal canal (8 lumbar and 2 thoracic). Low-back pain was the commonest presenting symptom, especially if the tumor was adherent to the conus medullaris. Other complaints included urinary dysfunction and motor and sensory disturbances of the legs. Clinical and radiological evidence of spina bifida was found in about half of the cases and suggested the diagnosis of a developmental type of tumor when patients presented with progressive spinal cord compression. At operation, the tumors were often found embedded in the conus medullaris or firmly adherent to the cauda equina, thus precluding complete removal. Evacuation of the cystic contents, however, gave lasting relief of the low-back pain and did not cause any deterioration in neurological function. In a follow-up study, ranging from 1 to 15 years, virtually no improvement in the neurological signs was observed. On the other hand, only one case has deteriorated due to recurrence of tumor growth.

X-ray-translucent retractors in spine surgery

1986 ◽  
Vol 64 (3) ◽  
pp. 520-521 ◽  
Author(s):  
Peter Knöringer
Keyword(s):  
Spine Surgery ◽  
Vertebral Column ◽  
Operating Time ◽  
Surgical Instruments ◽  
X Rays ◽  
Content Type ◽  
X Ray ◽  
Image Intensification ◽  
Fine Print

✓ With surgery of the vertebral column under image intensification, surgical instruments and conventional metal retractors often obscure important x-ray landmarks. Surgery is more difficult, operating time is longer, and exposure to x-rays is increased. The author has developed x-ray-translucent retractors for ventral and dorsal operations. Although for reasons of strength these retractors have somewhat more bulk than equivalent metal retractors, they are sufficiently stable and are compatible with spacial requirements. They can be sterilized and reused.

Paragangliomas of the lumbar region

2005 ◽  
Vol 2 (3) ◽  
pp. 354-365 ◽  
Author(s):  
Miguel Gelabert-González
Keyword(s):  
Cauda Equina ◽  
Lumbar Region ◽  
Rare Tumor ◽  
Content Type ◽  
Fine Print

✓ The author reports two cases of cauda equina paraganglioma (CEP) and provides a review of all previously published cases. The current radiological, neurosurgical, and pathological literature on this rare tumor is also reviewed.

Tethered cord syndrome in children with anorectal malformations

2000 ◽  
Vol 92 (4) ◽  
pp. 626-630 ◽  
Author(s):  
Natarajan Muthukumar ◽  
Bhuvaneswari Subramaniam ◽  
Thangaraj Gnanaseelan ◽  
Ramesh Rathinam ◽  
Appaswamy Thiruthavadoss
Keyword(s):  
Tethered Cord ◽  
Anorectal Malformations ◽  
Neurological Deficits ◽  
Radiographic Evidence ◽  
Content Type ◽  
X Ray ◽  
Neurological Improvement ◽  
Intraspinal Anomalies ◽  
Bone Abnormalities ◽  
Fine Print

Object. Anorectal malformations are known to be associated with neurological deficits, which may contribute to the disability suffered by patients with these malformations. This study was undertaken to determine the incidence and pattern of sacral abnormalities in children with anorectal malformations, the incidence and nature of the neurological deficits, and the incidence and nature of operable intraspinal abnormalities in patients with this condition.Methods. Neurological evaluation was performed in 81 children with anorectal malformations. Plain x-ray films were obtained to identify the presence of sacral abnormalities. The patients with neurological deficits were evaluated for the presence of operable intraspinal anomalies, and when such anomalies were identified, correction of the same was undertaken. In 21% of these children radiographic evidence of sacral abnormalities was shown. Fifteen percent of patients harbored neurological deficits, and 10% harbored operable intraspinal anomalies. In addition, one patient had split notochord syndrome. Patients with operable intraspinal anomalies underwent surgical correction, with resultant neurological improvement.Conclusions. Bone abnormalities of the sacrum, neurological deficits, and operable intraspinal lesions are not uncommon in children with anorectal malformations. Because the neurological deficits can contribute to the disability suffered by these individuals, we recommend routine screening of patients with anorectal malformations and neurological deficits and/or sacral abnormalities for the early identification and treatment of potentially correctable intraspinal lesions.

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