The results of treatment of acute injuries of the upper thoracic spine with paralysis.

Bohlman, Henry H.; Freehafer, Alvin A.; DeJak, J J

doi:10.2106/00004623-198567030-00002

Cited by 147 publications

(51 citation statements)

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“…Decompression can be expected to improve the neurological deficit, but the patient seldom makes a full recovery [4,10]. Traumatic esophageal perforation is associated with a high mortality rate (17-23%) [3,6,15].…”

Section: Discussionmentioning

confidence: 99%

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Fracture of the thoracic spine with paralysis and esophageal perforation

1997

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A 17-year-old young man presented with a highly unstable fracture dislocation of the third and fourth thoracic vertebrae with neurological deficit, in which the fractured spine had perforated the thoracic esophagus. Open reduction and internal fixation of the spinal fractures in combination with aggressive treatment of the mediastinitis caused by esophageal perforation, consisting of two re-thoracotomies, was performed. Two years after the accident, the patient had recovered well. The neurological deficit had recovered, and there were no difficulties with swallowing.

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Section: Discussionmentioning

confidence: 99%

“…Total recovery after treatment for a partial neurological deficit (the Brown-Sequard syndrome) is u n c o m m o n [4,10]. Esophageal perforation caused by a fracture of the thoracic spine is so rare that it has never previously been reported in the literature.…”

Section: Introductionmentioning

confidence: 99%

Fracture of the thoracic spine with paralysis and esophageal perforation

1997

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“…Obviously, preoperative function is a fairly good predictor of neurological outcome. 4,6,15 On the other hand, the clinical outcome with regard to neurological recovery seems unfavorable in paraplegic patients with thoracic spondyloptosis, such as the case reported here. 2,6,15 With good reduction and proper stabilization, however, this patient was able to continue his work and his social interactions in a wheelchair.…”

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confidence: 70%

“…2,5,6,[8][9][10][12][13][14][15][16][17][18] Under certain rare circumstances, however, despite significant anterior-posterior or lateral displacement, the patient can remain neurologically intact or be only mildly affected. 9,10,12,14,17,18 The reason for such neural sparing is quite interesting because a great discrepancy exists between the spectacular radiological features and the neurological picture.…”

Section: Discussionmentioning

confidence: 99%

“…2,5,6,8,13,15 However, surgery in patients with intact neural function is an extremely challenging process, particularly in those with normal neurological function, in whom preservation of neurological integrity is paramount. 1,4,9,10,12,14,[16][17][18][20][21][22] In such instances, surgical intervention should be carried out under neuromonitoring to avoid further injury to the spinal cord.…”

Section: Discussionmentioning

confidence: 99%

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Management of traumatic double-level spondyloptosis of the thoracic spine with posterior spondylectomy: case report

Rahimizadeh

2015

SPI

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Traumatic spondyloptosis of the thoracic spine is an uncommon injury. In most cases, spondyloptosis is confined to one vertebral body, whereas double-level spondyloptosis is extremely rare. Most patients who sustain traumatic spondyloptosis immediately become paraplegic, but in some cases neurological function is preserved. If this occurs, it is due to detachment of the pedicles from the corresponding vertebral body, resulting in spontaneous decompression of neural elements. Herein, the authors describe a case of undetected traumatic double-level spondyloptosis in the upper thoracic region in an adult male patient who was neurologically intact for 2 days but later became paraplegic. Initially, management of this pathology seemed a very challenging scenario. However, with review of the reconstructed CT images and reproduction of the injury on a plastic model, a posterior-only approach was chosen as an alternative operative solution for this catastrophic injury. Via this single-stage posterior approach, long-segment pedicle screw/rod instrumentation resulted in successful reduction, restoration of alignment, and stabilization after 1-level posterior spondylectomy. To the best of the authors’ knowledge, this is the first example reported in the literature of double-level spondyloptosis of the thoracic and the lumbar spine. This report describes the rationale, mechanism, and technical details afforded for reduction and stabilization of this rare injury.

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Spinal Disorders and Nerve Compression Syndromes

Yaghoobian

Olsewski²

2011

Principles and Practice of Geriatric Surgery

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The results of treatment of acute injuries of the upper thoracic spine with paralysis.

Cited by 147 publications

References 0 publications

Fracture of the thoracic spine with paralysis and esophageal perforation

Fracture of the thoracic spine with paralysis and esophageal perforation

Management of traumatic double-level spondyloptosis of the thoracic spine with posterior spondylectomy: case report

Spinal Disorders and Nerve Compression Syndromes

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