European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2000
Thoracolumbar distraction fractures in advanced pregnancy: a contribution of two case reports.
Клинический случайСтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
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Tanchev P, Dikov D, Novkov H
Аннотация
Thoracolumbar trauma in pregnant women is an important topic, though rarely discussed in the pertinent literature. Two consecutive cases of thoracolumbar distraction injuries in advanced pregnancy are presented. Conservative treatment failed in both cases; surgical management was necessary on a delayed basis using compression instrumentation. The similar features of the pattern of injury in the two patients suggest a cushioning effect of the gravid uterus. A theoretical analysis of the pathomechanics is carried out in an attempt to explain the specificity of flexion-distraction injuries in victims in an advanced stage of pregnancy. The authors suggest that the spine pivots about the fetus, and so is injured more in tension than in compression. The damage is mainly to soft-tissue structures, while anterior column compression and axial loading are less important.