scholarly journals Burst fracture Th 9-10 treat with Transthoracal Corpectomy and stabilization: A Cases Report

2019 ◽  
Vol 1 (2) ◽  
Author(s):  
Halim Rahman Manurung ◽  
Sabri Ibrahim ◽  
Ridha Dharmajaya
Keyword(s):  
Cervical Spine ◽  
Thoracic Spine ◽  
Burst Fracture ◽  
Thoracolumbar Spine ◽  
Spinal Fractures ◽  
High Energy ◽  
Spinal Fracture ◽  
Thoracolumbar Junction ◽  
Unstable Fracture ◽  
Burst Fractures

Abstract. Spinal fracture and dislocation are among the most feared injuries by patients and physicians alike, as the consequences can be devastating, ranging from mild pain and discomfort to severe paralysis and even death. Spinal trauma is commonly found in patients admitted to level-one trauma centers after serious accidents like traffic, falling, and sports accidents.Injuries of the cervical spine account for one third of spinal fractures and half to two thirds of all spinal cord injuries.In the thoracolumbar spine, the most common unstable fracture is the burst fracture. Altogether, burst fractures have been reported to account for about 15% of spinal injuries.Incidence of burst fractures peaked at the thoracolumbar junction and between levels T5 and T8. In 10% of cases,more than one burst fracture was seen, thereof 53% on noncontiguous levels. Main accident mechanisms were falls, traffic, and sports. Neurological deficit was highest in patients with burst fractures of the cervical spine, independent of accident mechanism, and lowest in thoracolumbar junction fractures. Burst fractures occur frequently in high energy traumas and are most commonly associated with falling and traffic accidents.Multiple burst fractures occur in 10% of cases, half thereof on noncontiguous levels.Access to the anterior thoracic spine via the transthoracic approach (via thoracotomy) can be used for decompression and fusion. To perform adequate decompression and stabilization of the thoracic spine, obtaining good exposure is a must. Preservation and protection of the vascular structures in the thoracic cavity is the key to such an exposure. Preoperative workup should include imaging modalities (plain rontgens, MRI/CT scan) to specifically define the area of decompression. If a tumor is being evaluated, CT angiography and embolization are helpful in preoperative planning. Assistance by a thoracic surgeon for exposure is highly recommended.

scholarly journals Incidence of flexion distraction injuries of thoraco lumbar spine

2020 ◽  
Vol 8 (2) ◽  
pp. 480
Author(s):  
Satheesh Kumar S.
Keyword(s):  
Lumbar Spine ◽  
Capacity Planning ◽  
Road Traffic ◽  
Tertiary Care ◽  
Thoracolumbar Spine ◽  
Spinal Fractures ◽  
Etiologic Factor ◽  
Trauma Patients ◽  
Spine Fractures ◽  
Burst Fractures

Background: Thoraco-lumbar spine fractures form majority of spine fractures and is an important cause of morbidity. However, comprehensive data regarding epidemiological pattern of trauma patients with spinal fractures are scarce. Many epidemiological reports about spinal fractures focus on osteoporosis as an etiologic factor. But in Indian population more important etiological factors are road traffic accidents and falls from height. Studies concerning only operatively treated patients with spinal fractures show selective and biased data that might be useful for capacity planning in hospitals or evaluating results of operative treatment, but not for epidemiological purposes. Methods: Among 86 consecutive patients with thoracic or lumbar fractures attending the out-patient department or Emergency department of Sree Gokulam Medical College, Trivandrum were enrolled in the study.  All patients with fractures of the thoracic or lumbar spine were enrolled in this study.Results: Flexion distraction injuries are the second commonest unstable thoracolumbar spine injuries.Conclusions: This study is a prospective cohort study of the epidemiological aspects and pattern of injury and treatment in thoraco-lumbar spine fractures at a tertiary care referral center. A total of 86 patients were enrolled in the study. The most common fracture pattern seen in this study was compression fractures (24.4%) which are stable. This was followed by stable burst fractures (23.2%, unstable burst fractures (18.6%), translational injuries (fracture-dislocations) (16.3%), flexion-distraction injuries (13.9%) and chance fractures (3.5%).

scholarly journals Burst Fracture of C5 with Traumatic Anterior Spondyloptosis of C6 and Posterior Spondylolisthesis of C4 Vertebra: A Case Report

2021 ◽  
Vol 59 (236) ◽  
Author(s):  
Poojan Kumar Rokaya ◽  
Nilam Kumar Khadka ◽  
Praveen Kumar Giri ◽  
Robin Khapung ◽  
Nirajan Mahaseth
Keyword(s):  
Cervical Spine ◽  
Cervical Spine Injury ◽  
Burst Fracture ◽  
Preoperative Assessment ◽  
High Energy ◽  
Spine Injury ◽  
Subaxial Cervical Spine ◽  
Injury Treatment ◽  
Posterior Instrumented Fusion ◽  
Anterior Posterior

Burst fracture of C5 with traumatic anterior spondyloptosis of C6 and posterior spondylolisthesis of C4 vertebra is an exceedingly rare high energy injury. Treatment includes decompression, reduction, stabilization, and fusion via anterior or posterior or combined anterior-posterior approach with or without prior traction. We report this rare subaxial cervical spine injury associated with quadriplegia managed with combined anterior and posterior instrumented fusion. A multidisciplinary approach with preoperative assessment and planning is crucial in managing cervical spine injury. Immediate postoperative critical care support, rehabilitation, and dedicated nursing care are required for a favorable outcome in traumatic quadriplegia.

scholarly journals Massive hemothorax due to bleeding from thoracic spinal fractures: a case series and systematic review

2020 ◽  
Vol 28 (1) ◽  
Author(s):  
Kohei Ninomiya ◽  
Akira Kuriyama ◽  
Hayaki Uchino
Keyword(s):  
Systematic Review ◽  
Burst Fracture ◽  
Spinal Fractures ◽  
Hemodynamic Instability ◽  
Spinal Fracture ◽  
Direct Compression ◽  
Care Hospital ◽  
Gauze Packing ◽  
Thoracic Spinal ◽  
Massive Hemothorax

Abstract Background Massive hemothorax secondary to thoracic spinal fractures is rare, and its clinical characteristics, treatment, and prognosis are unknown. We present two cases of thoracic spinal fracture-induced massive hemothorax and a systematic review of previously reported cases. Methods This study included patients with traumatic hemothorax from thoracic spinal fractures at a Japanese tertiary care hospital. A systematic review of published cases was undertaken through searches in PubMed, EMBASE, and ICHUSHI from inception to October 13, 2019. Results Case 1: An 81-year-old man developed hemodynamic instability from a right hemothorax with multiple rib fractures following a pedestrian–vehicle accident; > 1500 mL blood was evacuated through the intercostal drain. Thoracotomy showed hemorrhage from a T8-burst fracture, and gauze packing was used for hemostasis. Case 2: A 64-year-old man with right hemothorax and hypotension after a fall from height had hemorrhage from a T7-burst fracture, detected on thoracotomy, which was sealed with bone wax. Hypotension recurred during transfer; re-thoracotomy showed bleeding from a T7 fracture, which was packed with bone wax and gauze for hemostasis. The systematic review identified 10 similar cases and analyzed 12 cases, including the abovementioned cases. Inferior part of thoracic spines was prone to injury and induced right-sided hemothorax. Most patients developed hemodynamic instability, and some sustained intra-transfer hemorrhage; direct compression (gauze packing, bone wax, and hemostatic agents) was the commonest hemostatic procedure. The mortality rate was 33.3%. Conclusions Hemothorax due to thoracic spinal fracture can be fatal. Thoracotomy with direct compression is necessary in hemodynamically unstable patients.

scholarly journals CONSERVATIVE TREATMENT FOR THORACOLUMBAR SPINE BURST FRACTURES

2017 ◽  
Vol 16 (2) ◽  
pp. 127-132
Author(s):  
Barajas Vanegas Raymundo ◽  
Barajas Mota Raymundo ◽  
Villegas Domínguez Josué Eli ◽  
Hernández Álvarez María Betten
Keyword(s):  
Conservative Treatment ◽  
Selection Criteria ◽  
Burst Fracture ◽  
Thoracolumbar Spine ◽  
Neurological Injury ◽  
Bibliographic Databases ◽  
Prospective Design ◽  
Level Of Evidence ◽  
Burst Fractures ◽  
Free Search

ABSTRACT Objective: To identify the category of evidence and the strength of recommendation for the conservative treatment of thoracolumbar spine burst fractures. Method: A systematic review was conducted from April 2014 to June 2015, selecting articles according to their prospective design, related to thoracolumbar spine burst fractures and their treatment. These studies were published in the electronic bibliographic databases from January 2009 to January 2015. Results: A total of 9,504 articles were found in a free search, of which 7 met the selection criteria and were included for analysis in a study of a total of 435 patients, of whom 72 underwent surgical treatment and 363 received some type of conservative treatment, showing predominantly level of evidence "1b", with strength of recommendation type "A". Conclusions: According to the evidence obtained, the conservative treatment is a choice for patients with stable burst fracture in a single level of thoracolumbar spine and with no neurological injury.

scholarly journals A Rare Case of Contiguous Three-level Lumbar Burst Fractures-treated with Combined Posterior Stabilization and Anterior Fusion

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charanjit Singh Dhillon ◽  
Ahamed Shafeek Nanakkal ◽  
Nilay Prafulsinh Chhasatia ◽  
Narendra Reddy Medagam ◽  
Anandkumar Khatavi
Keyword(s):  
Lumbar Spine ◽  
English Literature ◽  
Burst Fracture ◽  
High Energy ◽  
Individual Characteristics ◽  
Neurological Deficits ◽  
Surgical Approaches ◽  
Anterior Fusion ◽  
Posterior Stabilization ◽  
Burst Fractures

Introduction: Burst fractures occur frequently in high energy trauma and are commonly associated with falls from height and road traffic accidents. While multiple burst fractures are not uncommon in thoracic spine, three or more contiguous level burst fractures are a relative rarity especially, in lumbar spine. The treatment of multilevel burst fractures must be individualized, and each fracture should be treated according to its inherent stability. To the best of our knowledge, this is the only case of such injury reported in English literature. Case Report: A 17-year-old girl who sustained contiguous three-level lumbar burst fractures with neurological compromise following alleged history of fall from height. Radiographs/computed tomography scan revealed burst fractures of L2, L3, and L4 vertebrae with retropulsion of bony fragments at all the levels. Patient underwent minimally invasive posterior stabilization and anterior Hemi-corpectomy of L2, L4, and fusion. The patient recovered completely from neurological deficits by the end of 6 months. Conclusion: Multiple contiguous burst fractures in the lumbar spine are a rare entity. To the best of our knowledge, this is the only case of such injury reported in English literature. The treatment requires a thorough assessment of the fracture pattern and often requires a combination of surgical approaches. Each fracture merits treatment based on individual characteristics of fracture patterns and the amount of canal compromise at each level. Keywords: Lumbar, burst fracture, multiple, contiguous.

Severe Thoracic Vertebral Spine Injury as a Complication of Component of Cardiopulmonary Resuscitation

2022 ◽  
pp. 000313482110586
Author(s):  
Elise F. Heidorn ◽  
Vicente Cortes ◽  
Adrian Ong
Keyword(s):  
Computed Tomography ◽  
Cardiopulmonary Resuscitation ◽  
Spinal Fractures ◽  
Spinal Fracture ◽  
Spine Injury ◽  
Unstable Fracture ◽  
Computed Tomography Scan ◽  
Chest Compressions ◽  
Electrical Shock ◽  
Tomography Scan

Chest compression has been a component of cardiopulmonary resuscitation (CPR) since 1960. Performance of high-quality CPR is critical for survival; however, chest compressions are traumatic and may result in injuries such as rib and sternal fractures. Spinal fractures have rarely been reported. We present a case of a 69-year-old male who suffered a cardiac arrest at home. He underwent 16 minutes of CPR with manual chest compressions, and no electrical shock and medications with return of spontaneous circulation (ROSC). Computed tomography scan showed unstable fracture of T9-T10. The patient was transferred to our Level I trauma center for continued post-arrest management and neurosurgical evaluation. An MRI confirmed the unstable spinal fracture which would have required surgical stabilization. The patient remained comatose, thus he was transitioned to comfort measures and expired. Spinal injuries following CPR are rare but should be considered in the post-arrest management stage. Computed tomography scan is the ideal screening modality.

scholarly journals Burst fracture of the thoracolumbar spine: correlation between kyphosis and clinical result of the treatment

2015 ◽  
Vol 14 (2) ◽  
pp. 129-133 ◽  
Author(s):  
Rodrigo Arnold Tisot ◽  
Juliano da Silveira Vieira ◽  
Renato Tadeu dos Santos ◽  
Augusto Alves Badotti ◽  
Diego da Silva Collares ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Burst Fracture ◽  
Thoracolumbar Spine ◽  
Cross Sectional Study ◽  
Statistical Correlation ◽  
Lumbosacral Spine ◽  
Cross Sectional ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Sf 36

<sec><title>OBJECTIVE:</title><p> To evaluate the correlation between kyphosis due to burst fractures of thoracic and lumbar spine and clinical outcome in patients undergoing conservative or surgical treatment.</p></sec><sec><title>METHODS:</title><p> A retrospective, cross-sectional study was conducted with 29 patients with thoracolumbar burst fractures treated by the Spine Group in a trauma reference hospital between the years 2002 and 2011. Patients were followed-up as outpatients for a minimum of 24 months. All cases were clinically evaluated by Oswestry and SF-36 quality of life questionnaires and the visual analogue scale (VAS) of pain. They were also evaluated by X-ray examinations and CT scans of the lumbosacral spine at the time of hospitalization and subsequently as outpatients by Cobb method for measuring the degree of kyphosis.</p></sec><sec><title>RESULTS:</title><p> There was no statistically significant correlation between the degree of initial kyphosis and clinical outcome measured by VAS and by most of the SF-36 domains in both patients treated conservatively and the surgically treated. The Oswestry questionnaire showed benefits for patients who received conservative treatment (p=0.047) compared to those surgically treated (p=0.335). The analysis of difference between initial and final kyphosis and final kyphosis alone in relation to clinical outcome showed no statistical correlation in any of the scores used.</p></sec><sec><title>CONCLUSION:</title><p> The clinical outcome of treatment of the thoracic and lumbar burst fractures was not influenced by a greater or lesser degree of initial or residual kyphosis, regardless of the type of treatment.</p></sec>

scholarly journals Biomechanical comparison of short-segment posterior fixation including the fractured level and circumferential fixation for unstable burst fractures of the lumbar spine in a calf spine model

2016 ◽  
Vol 25 (5) ◽  
pp. 602-609 ◽  
Author(s):  
Azad Sait ◽  
Nadipi Reddy Prabhav ◽  
Vijay Sekharappa ◽  
Reshma Rajan ◽  
N. Arunai Nambi Raj ◽  
...  
Keyword(s):  
Burst Fracture ◽  
Thoracolumbar Spine ◽  
Axial Rotation ◽  
Posterior Fixation ◽  
Lateral Flexion ◽  
Short Segment ◽  
Burst Fractures ◽  
Flexion Extension ◽  
Group A ◽  
Group B

OBJECTIVE There has been a transition from long- to short-segment instrumentation for unstable burst fractures to preserve motion segments. Circumferential fixation allows a stable short-segment construct, but the associated morbidity and complications are high. Posterior short-segment fixation spanning one level above and below the fractured vertebra has led to clinical failures. Augmentation of this method by including the fractured level in the posterior instrumentation has given promising clinical results. The purpose of this study is to compare the biomechanical stability of short-segment posterior fixation including the fractured level (SSPI) to circumferential fixation in thoracolumbar burst fractures. METHODS An unstable burst fracture was created in 10 fresh-frozen bovine thoracolumbar spine specimens, which were grouped into a Group A and a Group B. Group A specimens were instrumented with SSPI and Group B with circumferential fixation. Biomechanical characteristics including range of motion (ROM) and load-displacement curves were recorded for the intact and instrumented specimens using Universal Testing Device and stereophotogrammetry. RESULTS In Group A, ROM in flexion, extension, lateral flexion, and axial rotation was reduced by 46.9%, 52%, 49.3%, and 45.5%, respectively, compared with 58.1%, 46.5%, 66.6%, and 32.6% in Group B. Stiffness of the construct was increased by 77.8%, 59.8%, 67.8%, and 258.9% in flexion, extension, lateral flexion, and axial rotation, respectively, in Group A compared with 80.6%, 56.1%, 82.6%, and 121.2% in Group B; no statistical difference between the two groups was observed. CONCLUSIONS SSPI has comparable stiffness to that of circumferential fixation.

scholarly journals Creating reproducible thoracolumbar burst fractures in human specimens: an in vitro experiment

2016 ◽  
Vol 24 (4) ◽  
pp. 580-585 ◽  
Author(s):  
Ludwig Oberkircher ◽  
Maya Schmuck ◽  
Martin Bergmann ◽  
Philipp Lechler ◽  
Steffen Ruchholtz ◽  
...  
Keyword(s):  
Treatment Options ◽  
Thoracolumbar Spine ◽  
Neurological Impairment ◽  
High Energy ◽  
Classification Systems ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Before And After ◽  
Fixation Techniques

OBJECT The treatment of traumatic burst fractures unaccompanied by neurological impairment remains controversial and ranges from conservative management to 360° fusion. Because of the heterogeneity of fracture types, classification systems, and treatment options, comparative biomechanical studies might help to improve our knowledge. The aim of the current study was to create a standardized fracture model to investigate burst fractures in a multisegmental setting. METHODS A total of 28 thoracolumbar fresh-frozen human cadaveric spines were used. The spines were dissected into segments (T11–L3). The T-11 and L-3 vertebral bodies were embedded in Technovit 3040 (cold-curing resin for surface testing and impressions). To simulate high energy, a metallic drop tower was designed. Stress risers were used to ensure comparable fractures. CT scans were acquired before and after fracture. All fractures were classified using the AO/OTA classification. RESULTS The preparation and embedding of the spine segments worked well. No repositioning or second embedding of the specimen, even after fracture, was required. It was possible to create single burst fractures at the L-1 level in all 28 spine segments. Among the 28 fractures there were 16 incomplete burst fractures (Type A3.1), 8 burst-split fractures (Type A3.2), and 4 complete burst fractures (Type A3.3). The differences before and after fracture for stiffness and for anterior, posterior, and central heights were all significant (p < 0.05). CONCLUSIONS The ability to create reproducible burst fractures of a single vertebral body in a thoracolumbar spine segment may serve as a basis for future biomechanical studies that will provide better understanding of mechanical properties or fixation techniques.

Epidemiology of traumatic spinal fractures: experience from medical university–affiliated hospitals in Chongqing, China, 2001–2010

2012 ◽  
Vol 17 (5) ◽  
pp. 459-468 ◽  
Author(s):  
Hongwei Wang ◽  
Yuan Zhang ◽  
Qiang Xiang ◽  
Xuke Wang ◽  
Changqing Li ◽  
...  
Keyword(s):  
Accidental Falls ◽  
Traffic Accidents ◽  
Thoracolumbar Spine ◽  
Spinal Fractures ◽  
Spinal Fracture ◽  
Significant Difference ◽  
The Mean ◽  
Medical University ◽  
Mean Cost ◽  
Length Of Hospitalization

Object The main objective of this study was to analyze the epidemiological data obtained from patients with traumatic spinal fracture at 2 university-affiliated hospitals in Chongqing, China. Methods The authors retrospectively reviewed the hospital records of all patients who suffered traumatic spinal fracture and were treated at Xinqiao Hospital and Southwest Hospital (both affiliated with The Third Military Medical University) between January 2001 and December 2010. The demographic characteristics, injury characteristics, and clinical outcomes of patients over this 10-year period were compared. Results A total of 3142 patients (mean age 45.7 years, range 1–92 years) with traumatic spinal fractures were identified; 65.5% of the patients were male. The peak frequency of these injuries occurred in the 31- to 40-year-old age group. Accidental falls and traffic accidents were the most common causes of spinal fractures (58.9% and 20.9%, respectively). Traffic accidents tended to occur in younger patients, whereas accidental falls tended to occur in older patients. The most common area of fracture was the thoracolumbar spine (54.9%). Cervical spinal fractures were significantly more common in patients injured in traffic accidents, while lumbar spinal fractures were more common in accidental fall patients. Using the American Spinal Injury Association (ASIA) classification, 479 (15.3%) patients were classified as having ASIA A injuries; 913 (29.1%), ASIA B, ASIA C, or ASIA D; and 1750 (55.7%), ASIA E. ASIA A injuries were more common in patients who suffered thoracic spinal fractures (15.09%) than in those with fractures in other areas of the spine. A total of 954 (30.4%) patients had associated nonspinal injuries. Of these patients, 389 (40.78%) suffered a thoracic injury, and 191 (20.02%) sustained a head and neck injury. The length of hospitalization differed significantly between the accidental falls from high heights and falls from low heights, as did the mean cost of hospitalization (p < 0.05), but no significant difference was found between accidental falls from high heights and traffic accidents (p > 0.05). The length of hospitalization differed significantly among the 3 groups according to the ASIA classification, as did the mean cost of hospitalization (p < 0.05). Of patients with incomplete lesions, 39.3% improved 1 or more grades in ASIA classification during hospitalization. Conclusions Accidental falls emerged as the leading cause of traumatic spinal fracture in this study, and the numbers of fall-induced and sports-related injuries increased steadily with age. These results indicate that there should be increased concern for the consequences of fall- and sports-related injuries among the elderly.

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