Flexion-distraction Injuries of the Lumbar Spine and Associated Abdominal Trauma

Legay, D.; Petrie, David P.; Alexander, David

doi:10.1097/00005373-199004000-00013

Cited by 25 publications

(23 citation statements)

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“…Previous reports have described both delay in the diagnosis of abdominal patho logy in patients with known spinal injuries, as well as failure to initially recognize spinal injuries in patients with known abdominal trauma. 34,35 Treatment choices for flexion-distraction injuries Treatment of flexion-distraction injuries of the lumbar spine depends most notably on the perceived stability of the injury. Many regard the Chance fracture as stable in extension and have, therefore, treated these injuries non-operatively (usually with cast ing in extension).…”

Section: Missing Concomitant Injuriesmentioning

confidence: 99%

Pediatric seatbelt injuries: diagnosis and treatment of lumbar flexion-distraction injuries

Greenwald

Mann

1994

Spinal Cord

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Motor vehicle accidents are the major cause of flexion-distraction injuries of the thoracolumbar spine. In a retrospective review, we present the results of operative treatment for six pediatric patients who sustained such injuries while wearing seatbelts. There were three purely ligamentous injuries, two bony injuries (Chance fractures), and one combination injury. There were also concomitant neurological and intra-abdominal injuries. Of note is that two patients had either their spinal or abdominal injury missed on initial evaluation. All patients were treated surgically with open reduction and internal fixation. At average follow up of 2 years, all patients had a full range of motion with no back pain. Five had returned to their preinjury activity levels, while the sixth patient was paraplegic from his injury but was able to ambulate at home with crutches and knee-ankle-foot orthoses. We recommend operative reduction and two-level fusion of these injuries when (1) instability is apparent in either a purely ligamentous injury or an overtly unstable fracture-pattern, (2) significant kyphosis is present which cannot be reduced or maintained in a cast, or (3) there is associated neurological or intra-abdominal injury.

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Section: Missing Concomitant Injuriesmentioning

confidence: 99%

Pediatric seatbelt injuries: diagnosis and treatment of lumbar flexion-distraction injuries

Greenwald

Mann

1994

Spinal Cord

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“…5) of the lumbar spine, with many of these being rear seat passengers (LeGay et al, 1990;Ebraheim et al, 1991;Greenwald and Mann, 1994). This type of injury may be recognized later, since often the associated intra-abdominal injuries may dominate the early clinical presentation.…”

Section: Discussionmentioning

confidence: 99%

“…This type of injury may be recognized later, since often the associated intra-abdominal injuries may dominate the early clinical presentation. Neurological injury is rare (LeGay et al, 1990). The deceleration force of the upper and lower body is not dissipated in the pelvis or hip joint, but rather is driven into the lumbar spine (Johnson and Falci, 1990).…”

Section: Discussionmentioning

confidence: 99%

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Lap‐belt injury with complete avulsion of the spinal cord and cauda equina

Tubbs¹,

Golden²,

Doyle³

et al. 2005

Clinical Anatomy

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The authors report a child who was involved in an automobile accident. The patient was restrained by a rear seat lap belt. Radiological examination revealed an L4 Chance-type fracture and ligamentous disruption at the L4-L5 interval. During superficial dissection of the paraspinal muscles for a spinal fusion procedure, the cauda equina and the lower spinal cord (several centimeters) were visible, completely transected and herniated into the extraspinal space through a disrupted thoracolumbar fascia. The clinician should be aware of the potentially devastating results following a lap-belt injury in which a Chance fracture is produced.

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“…Local pain, tenderness and boggy swelling over the posterior lumbar spine are often present clinically. Abdominal organ injury commonly accompanies this fracture (up to 60% of the time), but diagnosis is often delayed (19). Similarly, in some cases, the abdominal organ injury is treated but there is delay in diagnosing the spinal fracture.…”

Section: Weight Group -27 Kg (60 Lbs) and Overmentioning

confidence: 99%

Children, automobile restraints and injuries

Howard

2000

Paediatrics &Amp; Child Health

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Flexion-distraction Injuries of the Lumbar Spine and Associated Abdominal Trauma

Cited by 25 publications

References 0 publications

Pediatric seatbelt injuries: diagnosis and treatment of lumbar flexion-distraction injuries

Pediatric seatbelt injuries: diagnosis and treatment of lumbar flexion-distraction injuries

Lap‐belt injury with complete avulsion of the spinal cord and cauda equina

Children, automobile restraints and injuries

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