UNSTABLE LUMBAR FRACTURE-DISLOCATION TREATED BY LONG SEGMENT POSTERIOR PEDICLE SCREW INSTRUMENTATION

Ferdiansyah Danang, Primadenny Ariesa Airlangga

= http://dx.doi.org/10.20473/joints.v9i2.2020.71-76
Abstract views = 442 times | downloads = 209 times

Abstract


Background: Among all the thoracolumbar fractures, 50-60% affects the thoracolumbar transitional zone, and 51% AO Type C Fractures has a neurological deficit. We experienced treating a case of unstable lumbar fracture-dislocation treated with long segment pedicle screw instrumentation.

Case: A 26-year-old man came to the ER after his back hit by a canopy while working 2 hours before admission. The motoric function was diminished from the L2-S1 level and hypoesthesia at the T12 level. Plain X-Ray showed Fracture-Dislocation Lumbar Vertebral 1-2 Denis Classification Flexion Rotation (AO Type C) ASIA A. The patient underwent reduction, decompression, and long-segment posterior pedicle screw instrumentation.

Discussion: The surgery’s primary purpose is to restore alignment and stability to improve the patient’s quality of life by enabling daily activity in a wheelchair without significant pain. Short segment or long segment pedicle screw instrumentation remains a debate. In this case report, we apply long segment pedicle screw instrumentation for lumbar vertebral fracture-dislocation.

Conclusion: Thoracolumbar fracture and dislocation fixation aim to restore alignment and stability, to reduce kyphotic deformity, and to decompress the spinal canal. The long segment pedicle screw instrumentation can resist the deforming force of thoracolumbar fractures and dislocations that will inevitably collapse into further kyphosis, resulting in a better outcome.


Keywords


Fracture-dislocation; Lumbar; Spine

Full Text:

PDF

References


Rajasekaran S, Kanna R, Shetty A. Management of thoracolumbar spine trauma An overview. Indian J Orthop. 2015;49(1):72.

Court-Brown, Charles; Tornetta (III) Paul, Heckman, James, McQueen, Margaret, Ricci, William, McKee M. Rockwood and Green's Fractures in Adults. 2014. 827–869 p.

Perry A, Newton PO, Garfin SR, Kim DH. Atlas of Spine Trauma: Adult and Pediatric [Internet]. 1st ed. Saunders,; 2008 [cited 2017 Dec 24].

Katsuura Y, Osborn JM, Cason GW. The epidemiology of thoracolumbar trauma: A meta-analysis. J Orthop. 2016;13(4):383–8.

Knop C, Blauth M, Bühren V, Hax PM, Kinzl L, Mutschler W, et al. Operative Behandlung von Verletzungen des thorakolumbalen Übergangs. Unfallchirurg. 1999;102(12):924–35.

Kim BG, Dan JM, Shin DE. Treatment of thoracolumbar Fracture. Asian Spine J. 2015;9(1):133–46.

Atlas SW, Regenbogen V, Rogers LF, Kim KS. The radiographic characterization of burst fractures of the spine. Am J Roentgenol. 1986;

Deng Z, Zou H, Cai L, Ping A, Wang Y, Ai Q. The retrospective analysis of posterior short-segment pedicle instrumentation without fusion for thoracolumbar burst fracture with neurological deficit. Sci World J. 2014;2014(1):1–9.

Aly, TA. Short segment versus long segment pedicle screws fixation in the management of thoracolumbar burst fractures: Meta-analysis. Asian Spine J. 2017;11(1):150–60.

Kim G-W, Jang J-W, Hur H, Lee J-K, Kim J-H, Kim S-H. Predictive factors for a kyphosis recurrence following short-segment pedicle screw fixation include fractured vertebral bodies in unstable thoracolumbar burst fractures. J Korean Neurosurg Soc. 2014;56(3):230–6.

Ugras A, Akyilidiz M, Yilmaz M, Sungur I, Cetinus E. Is it possible to save one lumbar segment in the treatment of thoracolumbar fractures ? Eur J Orthop Surg Traumatol. 2012;78:87–93.

Li J, Liu L. Comparison of short-segment versus long-segment fixation for thoracolumbar burst fracture treatment: A meta-analysis. Int J Clin Exp Med. 2017;10(2):1750–62.

McLain, RF. The biomechanics of long versus short fixation for thoracolumbar spine fractures [Internet]. Vol. 31, Spine. 2006 [cited 2017 Dec 25]. p. S70–9.

Raheem HQ. Comparison between short and long segment posterior spinal fixation in thoracolumbar burst fractures. Mustansiriya Med J. 2016;15(November 2015).


Refbacks

  • There are currently no refbacks.


Copyright (c) 2020 JOINTS (Journal Orthopaedi and Traumatology Surabaya)

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

JOINTS is indexed by:

          

 

JOINTS (Journal Orthopaedi and Traumatology Surabaya) (e-ISSN: 2460-8742, p-ISSN: 2722-712X) is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

 

 

View My Stats