scholarly journals Posterior Decompression with Fusion & Fixation by Pedicle Screw and Rod of Thoraco Lumbar Spine: A Study of 15 Cases

2013 ◽  
Vol 28 (2) ◽  
pp. 102-107
Author(s):  
Haradhan Deb Nath ◽  
Kanak Kanti Barua ◽  
Zillur Rahman ◽  
Md Rezaul Amin ◽  
Malay Kumar Das ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Spinal Injury ◽  
Treatment Plan ◽  
Thoracolumbar Spine ◽  
Spine Fracture ◽  
Unstable Fracture ◽  
Limb Weakness ◽  
Early Management ◽  
Number Of Patients ◽  
Fall From Height

Background & Objectives: Thoraco-lumbar fracture is one of the common problems in spinal injury patients. It’s early management can prevent complication after injury and can improve neurological function. The treatment plan of unstable fracture is controversial. Methods: The study was carried out at the department of neurosurgery, Bangabandhu Sheikh Mujib Medical University from June 2010 to July 2011 among the patients admitted with thoraco-lumbar spine fracture. Results: A total number of 15 patients with thoracolumbar spine fracture were included in the study. Among the 15 patients, 13(86.66%) were male. The highest number of patients were in age group of 1-20(40%) and 21-40(40%) years. The commonest cause of Thoraco-lumbar spine injuries were fall from height which was 8(53.33%) in number. The commonest site of injury was L1 fracture in 4(60%) patients. It was documented that bladder dysfunction and lower limb weakness were the commonest sign. It was evident that, 10(66.70%) and 4(26.66%) of the patients were partially and completely improved after surgery respectively and 3(10%) of patients had wound infection. Conclusion: Thoraco-lumbar spine fracture with incomplete injury, early surgery can improve many of the patient’s life. DOI: http://dx.doi.org/10.3329/bjn.v28i2.17181 Bangladesh Journal of Neuroscience 2012; Vol. 28 (2): 102-107

scholarly journals THORACOLUMBAR SPINAL ARTHRODESIS - EPIDEMIOLOGY AND COSTS

2017 ◽  
Vol 16 (1) ◽  
pp. 52-55
Author(s):  
TOBIAS LUDWIG DO NASCIMENTO ◽  
LUIZ PEDRO WILLIMANN ROGÉRIO ◽  
MARCELO MARTINS DOS REIS ◽  
LEANDRO PELEGRINI DE ALMEIDA ◽  
GUILHERME FINGER ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Neurological Deficit ◽  
Traffic Accidents ◽  
Thoracolumbar Spine ◽  
Hospital Costs ◽  
Spine Fracture ◽  
Female Ratio ◽  
Cord Injury ◽  
Fall From Height

ABSTRACT Objective: To describe the epidemiology of patients with thoracolumbar spine fracture submitted to surgery at Hospital Cristo Redentor and the related costs. Methods: Prospective epidemiological study between July 2014 and August 2015 of patients with thoracolumbar spine fracture with indication of surgery. The variables analyzed were sex, age, cost of hospitalization, fractured levels, levels of arthrodesis, surgical site infection, UTI or BCP, spinal cord injury, etiology, length of stay, procedure time, and visual analog scale (VAS) . Results: Thirty-two patients were evaluated in the study period, with a mean age of 38.68 years. Male-female ratio was 4:1 and the most frequent causes were fall from height (46.87%) and traffic accidents (46.87%). The thoracolumbar transition was the most affected (40.62%), with L1 vertebra involved in 23.8% of the time. Neurological deficit was present in 40.62% of patients. Hospital stay had a median of 14 days and patients with neurological deficit were hospitalized for a longer period (p<0.001), with an increase in hospital costs (p= 0.015). The average cost of hospitalization was U$2,874.80. The presence of BCP increased the cost of hospitalization, and patients with spinal cord injury had more BCP (p= 0.014) . Conclusion: Public policies with an emphasis on reducing traffic accidents and falls can help reduce the incidence of these injuries and studies focusing on hospital costs and rehabilitation need to be conducted in Brazil to determinate the burden of spinal trauma and spinal cord injury.

Curiosity or underdiagnosed? Thoracolumbar spinal column injuries with concomitant trauma of the pancreas

2020 ◽  
Author(s):  
Jakob Hax ◽  
Sascha Halvachizadeh ◽  
Kai Oliver Jensen ◽  
Till Berk ◽  
Henrik Teuber ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Spinal Injury ◽  
Thoracolumbar Spine ◽  
Pancreatic Injury ◽  
Spinal Injuries ◽  
Spine Injury ◽  
The Mean

Abstract Background: The pancreas is an organ which is at risk of damage as a consequence of thoracolumbar spine injury. However, to our knowledge, no studies have provided any prevalence data to support this assumption. Therefore, the coincidence of pancreatic trauma in patients with spine injury is still unknown. Data from the TraumaRegister DGU® (TR-DGU) was analysed to estimate the prevalence of this correlation and to determine its influence on clinical outcome.Methods: A retrospective investigation of cases documented in the TR-DGU between 2008 and 2017 was performed. We included data of patients admitted to participating European trauma centres who had thoracic or lumbar spine injuries and met the following criteria: i) Injury Severity Score (ISS) ≥ 9, ii) blunt trauma, and iii) no early transfer out of hospital. We investigated the coincidence of pancreas injury in patients with at least an Abbreviated Injury Scale (AIS) of 2 of the thoracic or lumbar spine. Therefore, we included all kind of relevant injuries of the thoracolumbar spine.Results: In the group with thoracolumbar injury with concomitant pancreatic injury, the mean age was 43.1 ± 18.6 years, and 68% of these patients were male. The most frequent mechanisms of trauma were car (38%) and motorbike (17%) accidents, as well as high falls (23.8%). The mean Injury Severity Score was 35.7 ± 16.0 points and the in-hospital mortality rate was 17.5%. The overall prevalence of pancreatic injury was 60.7 (0.61%; 95% confidence interval (CI), 0.58–0.65) per 10,000 patients. Patients with severe spinal injuries (AIS ≥ 2) were more likely to present with a concomitant pancreatic injury compared to patients with no or only minor spinal injury (AIS 0–1) (Odds ratio (OR) 1.78; 95%CI, 1.57–2.01).Conclusions: Concomitant pancreatic injury in patients with spinal injuries of the thoracolumbar spine is rare. However, patients with more severe spinal injuries were overall more likely (OR 1.78) to present with an accompanying pancreatic injury than those with minor thoracolumbar injuries. Therefore, trauma surgeons treating severely injured patients must be alert not to overlook this rare concomitant injury, because it does not clearly correlate with the severity of spinal injury.

scholarly journals Comparison of the Sagittal Spine Lordosis by Supine Computed Tomography and Upright Conventional Radiographs in Patients with Spinal Trauma

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Samy Bouaicha ◽  
Claudia Lamanna ◽  
Thorsten Jentzsch ◽  
Hans-Peter Simmen ◽  
Clément M. L. Werner
Keyword(s):  
Computed Tomography ◽  
Lumbar Spine ◽  
Cobb Angle ◽  
Sagittal Plane ◽  
Spinal Injury ◽  
Thoracolumbar Spine ◽  
Retrospective Data Analysis ◽  
Radiographic Measurements ◽  
Group A ◽  
Group B

Study Design.Retrospective data analysis.Objective.To compare the sagittal lordosis of the lumbar spine by supine computed tomography (CT) and upright conventional radiographs.Summary of Background Data.There is sparse data about position and modality dependent changes of radiographic measurements in the sagittal lumbar spine.Methods.The anatomical and functional Cobb angles of the thoracolumbar spine in 153 patients with spinal injury were measured by conventional upright sagittal radiographs and supine CT scans. Patients were assigned either to group A (n=101), with radiologically confirmed vertebral fractures, or to group B (n=52), without any osseous lesions. The interchangeability of the two imaging modalities was calculated using a ±3° and 5° range of acceptance.Results.Group A showed a mean intraindividual difference of −3.8° for both the anatomical and the functional Cobb angle. Only 25.7% and 27.7% of the 101 patients showed a difference within the tolerated ±3° margin. Using the ±5° limits, only 46 and 47 individuals fell within the acceptable range, respectively. In the patients in group B, the mean intraindividual difference was −2.1° for the anatomical and −1.5° for the functional Cobb angle. Of the 52 patients, only 14 and 13 patients, respectively demonstrated an intraindividual difference within ±3°. With regard to a threshold of ±5°, both the functional and anatomical values were within the defined margins in only 25 (48%) patients.Conclusion.The use of supine CT measurements as a baseline assessment of the sagittal lordosis of the injured thoracolumbar spine does not appear to be appropriate when upright conventional sagittal plane radiographs are used for follow-up measurements.

scholarly journals Management Strategy and Outcome of Epidural Haematoma in Relation to Volume

1970 ◽  
Vol 6 (2) ◽  
pp. 89-91
Author(s):  
MM Islam ◽  
TH Bhuiyan ◽  
MK Hassan ◽  
MATM Asadullah ◽  
Z Raihan ◽  
...  
Keyword(s):  
Management Strategy ◽  
Head Injuries ◽  
Epidural Haematoma ◽  
College Hospital ◽  
Early Management ◽  
Mortality And Morbidity ◽  
Male Predominance ◽  
Medical College ◽  
Number Of Patients ◽  
Fall From Height

Epidural Haematoma (EDH) develops in 1-3% of all major head injuries and most common in the young. This crosssectional descriptive study was done to find out the management strategy and outcome of EDH in relation to clot volume. This study was performed from December'2006 to November'2007, by purposively selecting 77 cases of EDH from the Department of Neurosurgery, Dhaka Medical College Hospital (DMCH), Dhaka. The study showed that highest number of patients was in most active period of life, with male predominance (Male: Female =7.5:1). Causes of EDH were mostly due to assault (37.7%), followed by RTA (32.5%) and fall from height (29.8%). The study showed Patient having EDH Volume (EDHV) > 30ml will have 8.55 times more chance of having unfavorable outcome than patient having EDHV < 30 ml. Patient having EDHV > 30 ml will have 187.83 times more chance of requiring surgical intervention than those having EDHV <30 ml, which is statistically highly significant (p<0.001). Mortality rate of EDH can be reduced by giving early management either conservative or surgery. Delay in the management of EDH patients with poor level of consciousness and EDHV >30 ml has adverse effect on mortality and morbidity. Key words: EDH; EDHV; Burr hole; GOS; GCS. DOI: http://dx.doi.org/10.3329/fmcj.v6i2.9208 FMCJ 2011; 6(2): 89-91

scholarly journals MDCT-Based Finite Element Analyses: Are Measurements at the Lumbar Spine Associated with the Biomechanical Strength of Functional Spinal Units of Incidental Osteoporotic Fractures along the Thoracolumbar Spine?

Diagnostics ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. 455
Author(s):  
Nico Sollmann ◽  
Nithin Manohar Rayudu ◽  
Long Yu Yeung ◽  
Anjany Sekuboyina ◽  
Egon Burian ◽  
...  
Keyword(s):  
Finite Element ◽  
Lumbar Spine ◽  
Fracture Risk ◽  
Thoracolumbar Spine ◽  
Areal Bone Mineral Density ◽  
Mineral Density ◽  
Osteoporotic Vertebral Fractures ◽  
The Mean ◽  
Biomechanical Strength

Assessment of osteoporosis-associated fracture risk during clinical routine is based on the evaluation of clinical risk factors and T-scores, as derived from measurements of areal bone mineral density (aBMD). However, these parameters are limited in their ability to identify patients at high fracture risk. Finite element models (FEMs) have shown to improve bone strength prediction beyond aBMD. This study aims to investigate whether FEM measurements at the lumbar spine can predict the biomechanical strength of functional spinal units (FSUs) with incidental osteoporotic vertebral fractures (VFs) along the thoracolumbar spine. Multi-detector computed tomography (MDCT) data of 11 patients (5 females and 6 males, median age: 67 years) who underwent MDCT twice (median interval between baseline and follow-up MDCT: 18 months) and sustained an incidental osteoporotic VF between baseline and follow-up scanning were used. Based on baseline MDCT data, two FSUs consisting of vertebral bodies and intervertebral discs (IVDs) were modeled: one standardly capturing L1-IVD–L2-IVD–L3 (FSU_L1–L3) and one modeling the incidentally fractured vertebral body at the center of the FSU (FSU_F). Furthermore, volumetric BMD (vBMD) derived from MDCT, FEM-based displacement, and FEM-based load of the single vertebrae L1 to L3 were determined. Statistically significant correlations (adjusted for a BMD ratio of fracture/L1–L3 segments) were revealed between the FSU_F and mean load of L1 to L3 (r = 0.814, p = 0.004) and the mean vBMD of L1 to L3 (r = 0.745, p = 0.013), whereas there was no statistically significant association between the FSU_F and FSU_L1–L3 or between FSU_F and the mean displacement of L1 to L3 (p > 0.05). In conclusion, FEM measurements of single vertebrae at the lumbar spine may be able to predict the biomechanical strength of incidentally fractured vertebral segments along the thoracolumbar spine, while FSUs seem to predict only segment-specific fracture risk.

scholarly journals Clinical Outcome of Single-Stage Decompression and Posterior Stabilization in Thoracolumbar Spinal Tuberculosis

2021 ◽  
Author(s):  
Patro Kumar Susanta ◽  
Nayak Biswaranjan ◽  
Krishnamurthy Holeppagol Balappa ◽  
Arun Kumar ◽  
Debabrata Biswal ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Spinal Injury ◽  
Spinal Tuberculosis ◽  
Thoracolumbar Spine ◽  
Single Stage ◽  
Posterior Stabilization ◽  
Surgical Interventions ◽  
Antitubercular Drugs ◽  
Impairment Score ◽  
Thoracolumbar Spinal Tuberculosis

Abstract Background Thoracolumbar spine constitutes the most common site for spinal tuberculosis. Though the treatment of spinal tuberculosis is antitubercular drugs initially, the patient with neurologic weakness warrants definitive surgical procedure of decompression and stabilization. Even though many investigators have reported favorable results with anterior decompression and stabilization surgery, due to the increased morbidity and complications, the posterior-only approach with decompression and stabilization has evolved as the operation of choice in recent time. Methods All patients aged between 18 and 70 years with clinically and radiologically proven symptomatic thoracolumbar spinal tuberculosis who failed with conservative treatment for 4 weeks or developed neurologic weakness between the treatments are included in this study. All patients were offered decompression and posterior stabilization with transpedicular screws and rods after explaining the above procedure. Clinical outcome was measured by modified Frankel grading; AIS (American Spinal Injury Association impairment score) grade impairment score; and pain assessment done with visual analog scale (VAS) pre- and postoperatively and at 3, 6, and 9 months of interval. Results The postoperative pain relief, neurologic improvement as per modified Frankel grade, AIS grade, and improvement in erythrocyte sedimentation rate and C-reactive protein were significant as compared with the preoperative status. The surgical interventions thus prove to have adequate relief to the patient and arresting the disease progression. The surgical outcome has very minimal intra- and postoperative complications. Conclusion Single-stage decompression and posterior stabilization in thoracolumbar spinal tuberculosis is safe, effective, and results in good clinical outcome. The advantages of surgery include thorough debridement, decompression, and achievement of spinal stabilization.

scholarly journals Rehabilitation in a case of severe osteoporosis with prevalent fractures in a patient known with multiple sclerosis and prolonged glucocorticoid therapy

2021 ◽  
Vol 12 (3) ◽  
pp. 284-288
Author(s):  
Florina-Ligia POPA ◽  
Madalina Gabriela ILIESCU ◽  
Mihaela STANCIU ◽  
Vlad GEORGEANU
Keyword(s):  
Multiple Sclerosis ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Glucocorticoid Therapy ◽  
Motor Deficit ◽  
Major Influence ◽  
Bone Mass Density ◽  
Severe Osteoporosis ◽  
Early Management ◽  
Vitamin D Levels

Introduction. Osteoporosis has a major influence on the quality of life because of its impact on bone strength. Osteoporosis and fractures are frequent in patients with multiple sclerosis, decreased mobility being an important risk factor in these patients. Objectives. This paper presents a case of severe osteoporosis in a patient with multiple sclerosis, to emphasize a correlation between this two pathologies. Material and Methods. We present the case of a female Caucasian patient, aged 65 years, known with progressive multiple sclerosis, on long-term use of glucocorticoids, and severe osteoporosis, who is investigated for mechanical pain and functional deficiency in the lumbar spine and the right hip, motor deficit, predominantly on right limbs and walking disorders. The patient was diagnosed with severe osteoporosis treated with raloxifene and bisphosphonates, with multiple vertebral fractures and vitamin D deficiency. During hospitalization the patient followed myorelaxant therapy and an individualized rehabilitation program. Results and discussion. During follow-up, there was a significant increase followed by a recent decrease in bone mass density in the lumbar spine and hip. The patient was recommended a loading dose of cholecalciferol for three months and initiation of teriparatide therapy after restoring 25-hydroxy vitamin D levels. Conclusion. In patients with multiple sclerosis,screening and early management of osteoporosis and osteopenia are essential. Keywords: multiple sclerosis, glucocorticoid therapy, osteoporosis,

Sign in / Sign up

Export Citation Format

Share Document