scholarly journals Classification of Radiological Changes in Burst Fractures

2018 ◽  
Vol 6 (2) ◽  
pp. 359-363
Author(s):  
Salim Şentürk ◽  
Ahmet Öğrenci ◽  
Ahmet Gürhan Gürçay ◽  
Ahmet Atilla Abdioğlu ◽  
Onur Yaman ◽  
...  
Keyword(s):  
Neurological Deficit ◽  
Clinical Status ◽  
Burst Fracture ◽  
High Energy ◽  
Organ Injury ◽  
Burst Fractures ◽  
Radiological Staging ◽  
Radiological Images ◽  
Radiological Changes

AIM: Burst fractures can occur with different radiological images after high energy. We aimed to simplify radiological staging of burst fractures.METHODS: Eighty patients whom exposed spinal trauma and had burst fracture were evaluated concerning age, sex, fracture segment, neurological deficit, secondary organ injury and radiological changes that occurred.RESULTS: We performed a new classification in burst fractures at radiological images.CONCLUSIONS: According to this classification system, secondary organ injury and neurological deficit can be an indicator of energy exposure. If energy is high, the clinical status will be worse. Thus, we can get an idea about the likelihood of neurological deficit and secondary organ injuries. This classification has simplified the radiological staging of burst fractures and is a classification that gives a very accurate idea about the neurological condition.

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.

Comparison of operative and nonoperative treatment for thoracolumbar burst fractures in patients without neurological deficit: a systematic review

2006 ◽  
Vol 4 (5) ◽  
pp. 351-358 ◽  
Author(s):  
Kenneth C. Thomas ◽  
Christopher S. Bailey ◽  
Marcel F. Dvorak ◽  
Brian Kwon ◽  
Charles Fisher
Keyword(s):  
Neurological Deficit ◽  
Data Extraction ◽  
Scientific Evidence ◽  
Burst Fracture ◽  
Nonoperative Treatment ◽  
Thoracolumbar Burst Fractures ◽  
Posttraumatic Kyphosis ◽  
Burst Fractures ◽  
Related Quality ◽  
Health Related

Object Despite extensive published research on thoracolumbar burst fractures, controversy still surrounds which is the most appropriate treatment. The objective of this study was to evaluate the scientific literature on operative and nonoperative treatment of patients with thoracolumbar burst fractures and no neurological deficit. Methods In their search of the literature, the authors identified all possible relevant studies concerning thoracolumbar burst fracture without neurological deficit. Two independent observers performed study selection, methodological quality assessment, and data extraction in a blinded and objective manner for all papers identified during the search. In a synthesis of the literature, the authors obtained evidence for both operative and nonoperative treatments. Conclusions There is a lack of evidence demonstrating the superiority of one approach over the other as measured using generic and disease-specific health-related quality of life scales. There is no scientific evidence linking posttraumatic kyphosis to clinical outcomes. The authors found that there is a strong need for improved clinical research methodology to be applied to this patient population.

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.

Surgical versus non-surgical treatment for thoracolumbar burst fractures without neurological deficit: A systematic review and meta-analysis v1

2021 ◽  
Author(s):  
Tzu-Yi Chou ◽  
Fon-yih Tsuang ◽  
Chung Liang Chai
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Neurological Deficit ◽  
Meta Analysis ◽  
Burst Fracture ◽  
Thoracolumbar Burst Fractures ◽  
Burst Fractures ◽  
Non Surgical Treatment

The aim of this systematic review is to compare the outcomes of burst fracture between non-operative treatments and operative treatments.

scholarly journals What is the importance of the spinal canal encroachment in the management of thoracolumbar burst fracture without neurological deficit?

2018 ◽  
Vol 21 (4) ◽  
pp. 234-238
Author(s):  
Fabrizio Borges Scardino ◽  
Alécio Cristino Evangelista Santos Barcelos ◽  
Vanessa Bizarri Da Silva ◽  
Paulo Augusto Silva Dumont ◽  
José Marcus Rotta ◽  
...  
Keyword(s):  
Neurological Deficit ◽  
Burst Fracture ◽  
Thoracolumbar Fracture ◽  
Neurological Deficits ◽  
Instability Criterion ◽  
Thoracolumbar Fractures ◽  
Neurological Damage ◽  
Surgical Indications ◽  
Burst Fractures ◽  
Canal Encroachment

Introduction: The relevant features in the treatment of thoracolumbar fractures vary in the literature. The classical surgical indications of burst fractures are loss of vertebral body height, kyphosis, neurological deficit and canal encroachment. Recent papers have attributed less importance to canal impingement as a surgical indicator in intact patients, irrespectively of the degree of encroachment. The several thoracolumbar fracture classifications have prompted efforts to guide the surgical indications. We analyzed the relevance attributed to the canal encroachment by thoracolumbar fracture classifications in the management of burst fractures without neurological deficit. Objective: To evaluate the relevance attributed by the thoracolumbar fractures classifications to the canal encroachment in the management of burst fractures without posterior ligamentous complex disruptions or neurological deficits. Methods: A literature search was performed by tracking the related articles of thoracolumbar fractures classifications from Vaccaro’s to Holdsworth’s study. We analyzed the role of canal impingement in the management of burst fractures without posterior ligament complex injury or neurological deficits in each classification. Results: Seven classifications were included. Holdsworth considered the burst fractures as stable, irrespectively of the amount of canal impingement or neurological deficit. Denis considered that the burst fracture carried a neurological instability criterion, therefore, in these cases he suggested surgical treatment because of the riskof new neurological damage. McAffee postulated that there is no reliable predictor to correlate the severity of canal encroachment with the risk of neurological damage. Ferguson and Allen discussed the possibility of anterior decompression, stabilization and anterior fusion of the spine in certain cases of burst fractures. The classifications of McCormack, Karaikovic and Gaines, Magerl and Vaccaro did not include canal encroachment in their considerations. Conclusion: The thoracolumbar fractures classifications did not directly consider the severity of canal encroachment in the treatment decision making of burst fractures without neurological damage. It is not possible to predict which patients will deteriorate if not operated. It remains unclear what is the risk of neurological deterioration in a SCE greater than 50%.

scholarly journals Transdural reduction of a bone fragment protruding into the spinal canal during surgical treatment of lumbar burst fracture: A case report

2021 ◽  
Vol 12 ◽  
pp. 406
Author(s):  
Wakiko Saruta ◽  
Toshiyuki Takahashi ◽  
Toshihiro Kumabe ◽  
Manabu Minami ◽  
Ryo Kanematsu ◽  
...  
Keyword(s):  
Spinal Canal ◽  
High Speed ◽  
Burst Fracture ◽  
Cauda Equina ◽  
High Energy ◽  
Sensory Function ◽  
Neurological Deficits ◽  
Burst Fractures ◽  
Cauda Equina Compression ◽  
Bone Fragments

Background: There have been many reports on the clinical, radiographic, and surgical management of thoracolumbar burst fractures attributed to high-energy trauma. Interestingly, few reports have described how to extract bone fragments associated with these injuries protruding into the spinal canal contributing to significant neurological deficits. Methods: An 18-year-old male presented with a severe L3-level paraparesis (i.e., loss of motor/sensory function below L3 lower extremity hyporeflexia, and sphincter dysfunction: American Spinal Injury Association [ASIA] Impairment Scale B) following a high-speed crash. The computed tomography and magnetic resonance studies revealed a L3 burst fracture with bone fragments protruding into the spinal canal causing marked cauda equina compression. Following a L3-L4 laminectomy, and opening of the dorsal dura, the bone fragments were ventrally impacted into the fractured L3 vertebral body a pedicle/screw L1-L5 fusion was then completed. Results: One month later, the patient recovered to an ASIA Scale of C, (i.e., residual proximal 3/5 and distal 2/5 motor deficits, with partial sensory sparing). Conclusion: Transdural ventral impaction of protruded bone fragments attributed to high speed lumbar burst fractures contributing to significant cauda equina compression can be safely/effectively accomplished.

Nonoperative Treatment

2007 ◽  
Vol 6 (1) ◽  
pp. 97 ◽  
Author(s):  
Stephen E. Natelson
Keyword(s):  
Neurological Deficit ◽  
Data Extraction ◽  
Scientific Evidence ◽  
Burst Fracture ◽  
Nonoperative Treatment ◽  
Thoracolumbar Burst Fractures ◽  
Posttraumatic Kyphosis ◽  
Burst Fractures ◽  
Related Quality ◽  
Health Related

Object Despite extensive published research on thoracolumbar burst fractures, controversy still surrounds which is the most appropriate treatment. The objective of this study was to evaluate the scientific literature on operative and nonoperative treatment of patients with thoracolumbar burst fractures and no neurological deficit. Methods In their search of the literature, the authors identified all possible relevant studies concerning thoracolumbar burst fracture without neurological deficit. Two independent observers performed study selection, methodological quality assessment, and data extraction in a blinded and objective manner for all papers identified during the search. In a synthesis of the literature, the authors obtained evidence for both operative and nonoperative treatments. Conclusions There is a lack of evidence demonstrating the superiority of one approach over the other as measured using generic and disease-specific health-related quality of life scales. There is no scientific evidence linking posttraumatic kyphosis to clinical outcomes. The authors found that there is a strong need for improved clinical research methodology to be applied to this patient population.

Controversies in Managing of Thoracic-Lumbar Upper Burst Fractures

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.

Functional Outcomes of Nerve Root Sparing Posterior Corpectomy in Lumbar Vertebral Burst Fractures

2021 ◽  
pp. 219256822098412
Author(s):  
Abhinandan Reddy Mallepally ◽  
Nandan Marathe ◽  
Abhinav Kumar Shrivastava ◽  
Vikas Tandon ◽  
Harvinder Singh Chhabra
Keyword(s):  
Blood Loss ◽  
Burst Fracture ◽  
Operating Time ◽  
Deformity Correction ◽  
Neurological Status ◽  
Height Loss ◽  
Vas Score ◽  
Post Surgery ◽  
Burst Fractures ◽  
The Difference

Study Design: Retrospective observational. Objectives: This study aimed to document the safety and efficacy of lumbar corpectomy with reconstruction of anterior column through posterior-only approach in complete burst fractures. Methods: In this retrospective study, we analyzed complete lumbar burst fractures treated with corpectomy through posterior only approach between 2014 and 2018. Clinical and intraoperative data including pre and post-operative neurology as per the ISNCSCI grade, VAS score, operative time, blood loss and radiological parameters, including pre and post-surgery kyphosis, height loss and canal compromise was assessed. Results: A total of 45 patients, with a mean age of 38.89 and a TLICS score 5 or more were analyzed. Preoperative VAS was 7-10. Mean operating time was 219.56 ± 30.15 minutes. Mean blood loss was 1280 ± 224.21 ml. 23 patients underwent short segment fixation and 22 underwent long segment fixation. There was no deterioration in post-operative neurological status in any patient. At follow-up, the VAS score was in the range of 1-3. The difference in preoperative kyphosis and immediate post-operative deformity correction, preoperative loss of height in vertebra and immediate post-operative correction in height were significant (p < 0.05). Conclusion: The posterior-only approach is safe, efficient, and provides rigid posterior stabilization, 360° neural decompression, and anterior reconstruction without the need for the anterior approach and its possible approach-related morbidity. We achieved good results with an all posterior approach in 45 patients of lumbar burst fracture (LBF) which is the largest series of this nature.

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