Chest Compression-induced Vertebral Fractures

Azuma, Steven; Mashiyama, Ernest T.; Goldsmith, Charles I.; Abbasi, Abdul S.

doi:10.1378/chest.89.1.154

Cited by 19 publications

(19 citation statements)

References 8 publications

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“…[1,2] However, vertebral body fracture following CPR has only been reported by four groups. Azuma et al [4] reported two cases: a 90-year-old man with rhabdomyolysis who received chest compressions for 60 minutes and whose autopsy revealed an eleventh thoracic vertebral compression fraction and a 71-year-old man who had cardiopulmonary arrest due to sepsis caused by a urinary tract infection. Our patient received compressions for 30-and 15-minute periods, and his autopsy revealed a first lumbar compression fracture.…”

Section: Discussionmentioning

confidence: 99%

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Multiple thoracic vertebral fractures as a complication of cardiopulmonary resuscitation: A case report

Jeong¹,

Lee

2016

Ulus Travma Acil Cerrahi Derg

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A 50-year-old man experienced cardiac arrest. The patient underwent standard cardiopulmonary resuscitative measures for approximately 20 minutes before spontaneous circulation returned. He was diagnosed with variant angina, and subsequent imaging for evaluation of upper back pain revealed fractures of the fifth through eighth thoracic vertebrae. Multiple thoracic vertebral fractures are extremely rare. Here we report a case of multiple thoracic vertebral fractures as a complication of cardiopulmonary resuscitation.

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Section: Discussionmentioning

confidence: 99%

“…[3] Vertebral body fractures can also occur; however, they are seldom observed, and multiple fractures rarely occur. [4] Here, we report a case of multiple thoracic vertebral body fractures sustained in a 50-year-old man during CPR.…”

Section: Introductionmentioning

confidence: 94%

Multiple thoracic vertebral fractures as a complication of cardiopulmonary resuscitation: A case report

Jeong¹,

Lee

2016

Ulus Travma Acil Cerrahi Derg

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“…[2][3][4][5] We here report a rare case of thoracic vertebral fracture associated with sternal fracture diagnosed after successful CPR in a 78-year-old man who later underwent surgery for decompression and fixation.…”

Section: Introductionmentioning

confidence: 93%

“…Two reports assumed that some degree of skeletal susceptibility such as osteoporosis, osteopenia, or kyphosis could be responsible for vertebral fractures during CPR. 3,5) Osteopenia is a well-known major risk factor for fractures of many types and dorsal kyphosis may also increase the lumbar lordosis exposing the spine to greater shearing forces during the chest compressions.…”

Section: Case Reportmentioning

confidence: 99%

“…Although thoracic spine fracture may not occur merely due to chest compressions during CPR, there are rare chances that the compressive strong forces may cause fracture in the presence of predisposing factors like fragile bone of old age or osteoporosis. 3,5,9) The incidence of spine fracture due to CPR appears very low; however, it may increase with the increasing elderly population in Japan along with the increased utility of CPR. So, early recognition of this complication could be helpful in preventing possible spinal cord damage from an unstable fracture.…”

Section: Case Reportmentioning

confidence: 99%

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Cardiopulmonary Resuscitation-induced Thoracic Vertebral Fracture: A Case Report

Bohara

Ohara²,

Mizuno³

et al. 2014

NMC Case Report Journal

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vein thrombosis developed which was treated with inferior vena cava filter placement. After the procedure, the patient developed sepsis that was being successfully managed. Meanwhile, he aspirated while eating bread leading to airway obstruction and cardiac arrest. Conventional CPR was performed and the patient recovered. He became conscious after extubation, and then he was found to be paraplegic. Radiological investigations of the spine were performed, which revealed dislocation fracture with hematoma at T6 thoracic level with severe spinal cord compression (Fig. 1a, b). The patient was then referred to our department. Computed tomography (CT) scan of chest demonstrated the fracture of sternum (Fig. 1c). On neurological examination, he showed Frankel grade A paraplegia. Spine surgery was performed 56 days after the cardiopulmonary resuscitation. The patient was transferred to our hospital after 9 days of the incident. Since the patient was diagnosed with sepsis caused by Staphylococcus aureus, he was medically treated until the infection was controlled and the blood culture was negative for three times, and his general condition was improved to be able to undergo instrumentation surgery. Posterior decompression was performed at T6 level by laminectomy, followed by pedicle screw fixation at T4-T8 levels (Fig. 2a). Intraoperatively, we found destruction of interspinous ligaments and the vertebral body was completely collapsed. Severe instability was observed at the affected level. But, there was no facet dislocation. We performed pedicle subtraction osteotomy (PSO) but did not employ reduction or any anterior reconstruction methods. After laminectomy and PSO, we aimed for in-situ fusion with segmental pedicle screw instrumentation. Postoperative CT scan at 5 months after surgery demonstrated good fracture healing with bony fusion (Fig. 2b) and postoperative T 2 -weighted MRI showed decompression of the spinal cord (Fig. 2c). The postoperative period (8 months as of this writing) has been uneventful. The patient recovered from Frankel grade A to C postoperatively. Unfortunately, the motor function could not be completely recovered and he has been undergoing rehabilitation. DiscussionChest compression is an integral part of CPR procedure. Although it is life-saving and undoubtedly the risks are acceptable for the survival value offered by it, the knowledge of possible complications is important so as to perform CPR as correctly as possible to prevent the avoidable complications.The most common complications of chest compression Thoracic vertebral fractures are very unusual complications of cardiopulmonary resuscitation (CPR). A 78-yearold man developed cardiac arrest after aspirating and conventional CPR was performed. After recovery, the patient had complete paraplegia (Frankel grade A). Magnetic resonance image of spine showed a dislocation fracture with hematoma at T6 thoracic level. Computed tomography scan of chest revealed the fracture of sternum. After the patient's condition became stable with subsequent m...

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Resuscitation Injuries

Leadbeatter¹

2001

Essentials of Autopsy Practice

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Chest Compression-induced Vertebral Fractures

Cited by 19 publications

References 8 publications

Multiple thoracic vertebral fractures as a complication of cardiopulmonary resuscitation: A case report

Multiple thoracic vertebral fractures as a complication of cardiopulmonary resuscitation: A case report

Cardiopulmonary Resuscitation-induced Thoracic Vertebral Fracture: A Case Report

Resuscitation Injuries

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