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To assess the efficacy and feasibility of vertebroplasty and posterior short-segment pedicle screw fixation for the treatment of traumatic lumbar burst fractures. Short-segment pedicle screw instrumentation is a well described technique to reduce and stabilize thoracic and lumbar spine fractures. It is relatively a easy procedure but can only indirectly reduce a fractured vertebral body, and the means of augmenting the anterior column are limited. Hardware failure and a loss of reduction are recognized complications caused by insufficient anterior column support. Patients with traumatic lumbar burst fractures without neurologic deficits were included. After a short segment posterior reduction and fixation, bilateral transpedicular reduction of the endplate was performed using a balloon, and polymethyl methacrylate cement was injected. Pre-operative and post-operative central and anterior heights were assessed with radiographs and MRI. Sixteen patients underwent this procedure, and a substantial reduction of the endplates could be achieved with the technique. All patients recovered uneventfully, and the neurologic examination revealed no deficits. The postoperative radiographs and magnetic resonance images demonstrated a good fracture reduction and filling of the bone defect without unwarranted bone displacement. The central and anterior height of the vertebral body could be restored to 72 and 82% of the estimated intact height, respectively. Complications were cement leakage in three cases without clinical implications and one superficial wound infection. Posterior short-segment pedicle fixation in conjunction with balloon vertebroplasty seems to be a feasible option in the management of lumbar burst fractures, thereby addressing all the three columns through a single approach. Although cement leakage occurred but had no clinical consequences or neurological deficit.

This technique prevents a large incision, does not require a special IOL as in transscleral suture fixation, and results in a low endothelial cell loss.

Abstract. A female paraplegic developed intraperitoneal rupture of urinary bladder seven weeks after institution of indwelling urethral catheter drainage. Blockage of the catheter precipitated this fatal event. Oliguria after an initial encouraging urinary output despite adequate fluid replacement led us to suspect bladder rupture which was con firmed by urgent cystography. Although emergency laparotomy to repair the rent in the bladder was performed, she succumbed to gram-negative septicemia. Other hazards of indwelling urethral catheter drainage even for short periods are highlighted (though the above complication itself is admittedly rare) with an oft re-emphasised plea to con sider earlier the alternative modality of intermittent catheterisation or pharmacotherapy in female patients.

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