World neurosurgery · 2016
Floating Thoracic Spine After Double, Noncontiguous Three-Column Spinal Fractures.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Salehani Arsalaan A, Baum Griffin R, Howard Brian M, Holland Christopher M, Ahmad Faiz U
Аннотация
BACKGROUND: Double, noncontiguous, 3-column spinal injuries are a rare phenomenon most often caused by high-energy trauma. The resulting multilevel, fracture-dislocation injuries represent 2 separate 3-column lesions and produce a floating spine segment between the 2 fracture dislocation sites. Only a few cases of these rare, posttraumatic injuries have been reported previously; however, all of these included a combination of injuries in the cervical, thoracic, lumbar, and/or sacral spine.
CASE DESCRIPTION: We present the first report of a case of double-level spinal injury isolated to the thoracic spine, with an intermediate floating spinal segment in a 48-year-old man after a 30-foot fall. In our case, the standard 3 above and 2 below pedicle instrumentation was not sufficient to stabilize the thoracic spine.
CONCLUSIONS: We consider the evaluation and surgical management of these fractures and discuss how a standard "3 above-2 below" approach may not be sufficient to stabilize these unstable injuries. In the case of severe, noncontiguous double chance fractures of the spine, we recommend a more extensive anteroposterior approach to reduce the risk of hardware failure and worsening spinal deformity.
CASE DESCRIPTION: We present the first report of a case of double-level spinal injury isolated to the thoracic spine, with an intermediate floating spinal segment in a 48-year-old man after a 30-foot fall. In our case, the standard 3 above and 2 below pedicle instrumentation was not sufficient to stabilize the thoracic spine.
CONCLUSIONS: We consider the evaluation and surgical management of these fractures and discuss how a standard "3 above-2 below" approach may not be sufficient to stabilize these unstable injuries. In the case of severe, noncontiguous double chance fractures of the spine, we recommend a more extensive anteroposterior approach to reduce the risk of hardware failure and worsening spinal deformity.