Total Vertebrectomy and Spine Shortening in the Management of Acute Thoracic Spine Fracture Dislocation

Abstract

Complete vertebrectomy and spinal shortening can be used in the acute phase to manage thoracic spine fracture-dislocations.

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

“…12 In some fracture-dislocations, the resection of the injured disc and partial corpectomy of the inferior vertebra involved might be enough to allow reduction and superimposition of the adjacent vertebrae. All preoperative images of T4-5, T6-7, and T9-10 dislocations presented by Obeid et al 22 showed traumatic hemothoraxes that might have been related to the spine fractures themselves or to other injuries not mentioned in the report. However, the postoperative period was uneventful.…”

“…8,37 Barberá 1 reported the case of a young posttraumatic paraplegic patient (ASIA Grade A) with severe chronic (8 months) thoracolumbar (T12-L1 telescoped) kyphotic deformity that was corrected by a single-level spondylectomy with spine shortening; this was accomplished using a posterior approach. Obeid et al 22 reported total vertebrectomy and spine shortening for acute thoracic spine fracture dislocation. They described some advantages of this technique, such as a single approach (posterior) and the fact that the apposition of the adjacent healthy endplates permits an excellent reconstruction of the anterior spinal column and might provide an excellent interbody fusion rate.…”

“…5,14,25 There are few reports concerning total vertebrectomy and spine shortening in the treatment of traumatic injuries, all of them involving paraplegic patients. 1,22 Although this technique provides decompression of the spinal canal and spine stabilization, this is essentially a mechanical surgery. In spite of the great efforts to date to improve neurological function after SCI, patients with complete lesions (ASIA Grade A), especially above T-9, are not expected to achieve functional recovery.…”

“…15 Since then, this technique has been used in the management of congenital, 7,21,27,28 tumoral, 17,29 infectious, 23,32,34 deformity, [2][3][4]30,31 degenerative, 9,10,13 and (recently) traumatic disorders. 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.…”

Total vertebrectomy for stabilisation of chronic spinal lumbar luxation in a paraplegic dog without nociception

“…It was first described for the treatment of scoliosis, and since then, this technique has been used in humans in the management of congenital, tumoural, infectious, deformity, degenerative and traumatic disorders (Obeid et al . ). In veterinary medicine, Chauvet et al .…”