Thoracolumbar Spine Trauma

Treatment of Complete Fracture-dislocation of Thoracolumbar Spine

“…8,10,13 Conservative treatment has only been recommended in older patients or those with severe underlying disease or complication. 16 Vertebral overriding existed in all the patients. These injuries are usually treated using posterior segmental instrumentation and fusion.…”

Treatment of subacute thoracic spine fracture-dislocation by total vertebrectomy and spine shortening

“…In cases of vertebral fracture-dislocation, some authors recommend a combined anterior-posterior approach with corpectomy, anterior support implant, and further posterior instrumentation. 5,18,24,36 The posterolateral approaches such as lateral extracavitary and costotransversectomy also allow surgeons to access the ventral thoracic spine for a wide range of spinal disorders including tumor, degeneration, infection, and trauma. 14,33 As stated in his comment on a paper by Resnick and Benzel, 25 Sonntag thought that these approaches are appropriate for an injury such as a fracture subluxation of the thoracic and thoracolumbar spine, for which both anterior and posterior approaches may be indicated.…”

“…1,22 The current technique for vertebral fracture-dislocation when there is partial or total telescoping of the involved vertebrae is a combined anterior-posterior approach with corpectomy, anterior support implant, and further posterior instrumentation. 24,36 These procedures usually require 2 surgical teams, involve longer operating times and greater risk of surgical complications related to the anterior approach, and commonly entail longer postoperative care before discharge.…”

Complete thoracolumbar fracture-dislocation with intact neurologic function: Explanation of a novel cord saving mechanism

“…[1][2][3][4][5] In the majority of translational or rotational fracture dislocations, the neural arch remains intact; hence, patients with such injuries immediately suffer paraplegia because of severe cord compromise. [1][2][3][4][5] Nevertheless, in certain rare cases of complete fracture dislocation of the vertebral column, the patient remains neurologically normal, 4, The mechanism of preservation of normal neurologic status is free-floating laminas or the saving fracture of the vertebral arch, in which unilateral or bilateral pedicular shear allows the posterior elements to remain almost aligned, with the ability to preserve the spinal canal integrity and maintain normal neurologic function of the spinal cord, despite gross displacement of the corresponding body. 4, A careful review of the literature showed that only 6 cases of complete thoracolumbar fracture dislocation with intact neurologic function have been reported previously.…”

“…[1][2][3][4][5] Nevertheless, in certain rare cases of complete fracture dislocation of the vertebral column, the patient remains neurologically normal, 4, The mechanism of preservation of normal neurologic status is free-floating laminas or the saving fracture of the vertebral arch, in which unilateral or bilateral pedicular shear allows the posterior elements to remain almost aligned, with the ability to preserve the spinal canal integrity and maintain normal neurologic function of the spinal cord, despite gross displacement of the corresponding body. 4, A careful review of the literature showed that only 6 cases of complete thoracolumbar fracture dislocation with intact neurologic function have been reported previously. 14,15,[28][29][30][31] This study represents a case in which a 19-year-old female sustained severe rotational dislocation of L1 on L2, with considerable anterolateral displacement, who nevertheless remained neurologically intact.…”