scholarly journals Rehabilitation Strategies in Management of Complex Case of Cervical Burst Fracture- A Case Report

2021 ◽  
pp. 205-208
Author(s):  
Rishika H. Gabada ◽  
Pooja Kasatwar ◽  
Chaitanya A. Kulkarni
Keyword(s):  
Ct Scan ◽  
Vertebral Body ◽  
Motor Vehicle ◽  
Burst Fracture ◽  
Compression Fracture ◽  
Complex Case ◽  
Fracture Dislocation ◽  
X Rays ◽  
Spinal Compression ◽  
Spinal Compression Fracture

A burst fracture is a descriptive term for an injury to the spine in which the vertebral body is severely compressed. They typically occur from severe trauma, such as a motor vehicle accident or a fall from a height. With a great deal of force vertically onto the spine, a vertebra may be crushed .If it is only crushed in the front part of the spine, it becomes wedge shaped and is called a compression fracture. However, if the vertebral body is crushed in all directions it is called a burst fracture. Burst fractures cause severe pain. The diagnosis of a burst fracture is usually made by x-rays and a CT scan. Occasionally, an MRI scan may be ordered as well, in order to assess the amount of soft tissue trauma, bleeding or ligament disruption. The review of the CT scan and x-rays allows the treating physician to make a determination as to the level of the fracture, whether it is a compression fracture, burst fracture or fracture dislocation. A spinal compression fracture also may be caused by trauma to the spine. Events that may cause trauma to the spine can include: A car accident, a hard fall or a fall from a height of more than 15 feet, landing on the feet, and a blow to the head. Any fall from a standing height that results in a spinal compression fracture or any other fracture most likely indicates weak bones due to osteoporosis. The physical exam should be performed to document both spinal deformity, that is, angulation of the spine or tenderness of the spine at the level of fracture, as well as, a neurologic exam. Neurologic exam should include testing of the muscle strength, sensation, and reflexes of the lower extremities, as well as, testing of bowel and bladder sphincter control. A 36 year old man was brought to the hospital as he had a fall from electric pole approximately 20 feet height. He had sustaining injury to the neck. Surgery was done as patient was diagnosed with C6 burst fracture with fracture dislocation of C5-C7. Therapeutic Interventions includes exercises, strengthening exercises, cervical fracture fixation, and traction.

scholarly journals Traumatic Posterior L4–L5 Fracture Dislocation of the Lumbar Spine: A Case Report

2012 ◽  
Vol 2 (4) ◽  
pp. 235-238 ◽  
Author(s):  
Baron Zarate-Kalfopulos ◽  
Samuel Romero-Vargas ◽  
Cesar Alcántara-Canseco ◽  
Luis Miguel Rosales-Olivarez ◽  
Armando Alpizar-Aguirre ◽  
...  
Keyword(s):  
Case Report ◽  
Lumbar Spine ◽  
Ct Scan ◽  
Vertebral Body ◽  
High Energy ◽  
Fracture Dislocation ◽  
X Rays ◽  
Lower Extremity Muscle ◽  
Lower Lumbar Spine ◽  
Muscle Groups

Study Design Case report. Objective The diagnosis and surgical management of a patient with traumatic bilateral posterior dislocation of L4–L5 is presented with a thorough review of the existing literature. Summary of Background Data Traumatic dislocation of L4–L5 has been reported in the English literature in only five cases; of these, only two were retrolisthesis. Methods A 20-year-old patient was involved in a high-energy vehicular accident and presented with back pain and inability to ambulate. Neurological assessment showed motor strength grade 2/5 in the proximal lower-extremity muscle groups (L1–L3 myotomes) and 0/5 strength distally (L4–S1 myotomes); in addition, incontinence of sphincters was found. X-rays and computed tomography (CT) scan revealed a three-column ligamentous injury with posterior fracture-dislocation of the L4 vertebral body with complete posterior displacement of L4 to L5 vertebral body. The patient underwent posterior approach with reduction, transpedicular fixation, and posterolateral fusion with autologous bone graft. Results At 1-year follow-up, the patient had recovered muscular strength in proximal lower-extremities muscle groups, sphincter function had fully recovered, and he was able to ambulate with crutches. There was no recovery of distal extremity sensorimotor function. Plain radiograph and CT scan showed good alignment and progressive maturation of his fusion procedure. Conclusion Traumatic retrolisthesis of L4–L5 is a high-energy unstable fracture; reduction of the dislocation is challenging because of the heavy forces acting in the lower lumbar spine. Instrumented fusion restores alignment and maintains segmental stability.

scholarly journals Spinal Compression Fracture Management

2017 ◽  
Vol 7 (1) ◽  
pp. 71-82 ◽  
Author(s):  
Ivo K. Genev ◽  
Matthew K. Tobin ◽  
Saher P. Zaidi ◽  
Sajeel R. Khan ◽  
Farid M. L. Amirouche ◽  
...  
Keyword(s):  
Compression Fracture ◽  
Fracture Management ◽  
Spinal Compression ◽  
Spinal Compression Fracture

scholarly journals LOWER CERVICAL FRACTURE AND DISLOCATIONS

2018 ◽  
Vol 25 (02) ◽  
pp. 185-190
Author(s):  
Faisal Abdul Jabbar ◽  
Abdul Ali Khan ◽  
Rehana Ali Shah
Keyword(s):  
Spinal Cord ◽  
Cervical Spine ◽  
Burst Fracture ◽  
Tertiary Care ◽  
Insertion Site ◽  
Fracture Dislocation ◽  
X Rays ◽  
Cord Injury ◽  
Screw Breakage ◽  
Set Up

Objectives: The aim of our study is to determine the outcome of cervical pediclescrew fixation for fractures/dislocations of the cervical spine at our set up in Karachi, Pakistan.Study Design: A prospective case series. Period: 04 years duration from January 2013 toDecember 2016. Setting: Tertiary Care Centre in Karachi, Pakistan. Method: All the patientswho were included in the study signed a full informed consent. The inclusion criterion was allthe patients who cervical spine fracture/dislocation, presented to us within 24 hours of injuryand were operated at our set up. Data was collected in a predesigned proforma which includeda complete history and physical examination, age, gender, cause of injury, co morbidities, preoperativeradiological findings, past medical and surgical history. Serial X rays, MRI and CTscans were taken at 3, 6, 12 and 24 months post operatively for evaluation of stability, fusion andany complication such as deformity. The American Spinal Cord Injury Association impairmentscale was utilized in all the patients at follow ups to determine the sensory and motor functionimprovement post operatively. Data was analyzed using IBM SPSS for windows version 21.Results: The study population consisted of n= 40 patients of which n= 28 were male andn= 12 were female with a mean age of 45.2 years. The various types of injuries sustained bythe patients were as follows, n= 6 (15%) cases of cases had compression fractures (vertical),n=15 (37.5%) had flexion rotation injury and n=19 (47.5%) had flexion compression fracturesrespectively. While the division of bony injuries in the patient was as follows, n=5 (12.5%) hadcervical spinal burst fracture with dislocation, n= 15 (37.5%) patients had joint facet fracturewith dislocation bilaterally along with compression fracture of the vertebral body, n= 14 (35%)patients had facet joint fracture with dislocation bilaterally and n= 6 (15%) had unilateral fracturedislocation of joint facet. Complications such as injury to the vertebral artery, spinal cord, nerveroot were not observed in any of the patients in this series, all the patients achieved full bonyfusion at the 6 month follow up as observed on radiographic images. We also did not find anyincidence of screw penetration into the pedicle, similarly no incidence of screw breakage orloosening was observed. N=24 patients with incomplete injury of the spinal cord showedimprovements in their ASIA impairment scale, the patients n= 15 who had a complete spinalcord injury failed to show any improvement post operatively, but reported some decrease in painand numbness post operatively. Conclusion: For fractures/dislocations of the cervical spine thecervical pedicle screw is a reliable and effective method and provides good stability and bonyfusion. However the technique is dependent on surgeons experience and the extensive use ofpre-operative imaging to select the best insertion site of the screws as individualized for everypatient accordingly.

scholarly journals Traumatic intradural ruptured lumbar disc with a spinal compression fracture

Medicine ◽  
2020 ◽  
Vol 99 (7) ◽  
pp. e19037 ◽  
Author(s):  
Gwangjun Lee ◽  
Moon-Soo Han ◽  
Seul-Ki Lee ◽  
Bongju Moon ◽  
Jung-Kil Lee
Keyword(s):  
Lumbar Disc ◽  
Compression Fracture ◽  
Spinal Compression ◽  
Spinal Compression Fracture
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