Seating in a motor vehicle, particularly on the last row in a bus, as it passes over a speed hump may cause severe traumatic spine injuries. These fractures occur more frequently at the thoracolumbar junction and treatment may require surgery.

There are only few reports in literature about the treatment of traumatic lesions of the thoracic spine. They have been grouped together with thoracolumbar fractures, ignoring the particular biomechanics of the thoracic segment. The objective of this retrospective cohort is to describe the clinical presentation and outcomes of surgically treated patients with these injuries. Data were obtained from the institutional database of medical registries, identifying all the patients who had been treated for thoracic spine fractures, from January 1, 1995 through December 31, 2005 in our institution. The study group included the 51 surgically treated patients. General and surgery-related complications were considered as clinical outcomes and injury-related disability was also assessed. Statistical analysis evaluating possible associations with timing and type of surgery, neurological impairment and associated injuries was carried out. Motor vehicle accident was the most frequent mechanism of injury. Six patients had an incomplete neurological deficit, whereas 22 had a complete lesion. Thirty-two patients presented at least one complication. Five of the neurologically intact patients, while 20 of those with neurological impairment presented general complications (p = 0.0001). None of the patients' neurological status deteriorated after surgery. All patients with complete spinal cord injury and those with incomplete cord injury with partial functional recovery received disability compensation. Short pedicle instrumentations should be used whenever possible, but also long instrumentations and mixed constructs may be necessary for the management of such unique fractures.

No abstract

No abstract

Introduction Currently, the anterior cervical discectomy and fusion (ACDF) is the “gold standard” treatment after anterior cervical decompression, in elderly patients or those who have contraindications for disc prosthesis. In this context, a new anchored implant with zero profile has been introduced for ACDF, which seeks to solve the problems that entail to add an anterior cervical plate and to obtain a higher level of stability to the segment, in comparison with cage only. The objective of this study is to describe the operative and postsurgical results, associated to the new zero-profile implant COALITION (Globus Medical, Inc, Audubon, Pennsylvania, United States), in patients who had surgery after cervical spine degenerative disease. Materials and Methods The data of 32 patients were reviewed by the Spine surgeons of Hospital del Trabajador (Santiago de Chile), between 2011 and 2014 under the ACDF technique using COALITION, in the context of cervical degenerative disease. The operative time, ambulation start, hospital stay, and dysphagia and dysphonia were measured. Results The patients had an average age of 51.64 ± 9.78 DE, on a male/female ratio of 16/15. A total of 53 levels were obtained (C3–C4: 3, C4–C5: 12, C5–C6: 20, and C6–C7: 18). The operative time was an average of 167.64 ± 50.28 minutes, using autologous iliac crest graft. The ambulation start time was 1 day (range, 1–2 days), with a hospital stay of 4 days (range, 2–7 days). The immediate dysphagia in postoperative was 56.25%, from this 77.77% was mild according to Bazaz score. Only 22.2% of the patients with immediate dysphagia persisted with a mild level, according to Bazaz score after 1 week of discharge from hospital. None of the patients presented chronicle dysphagia. Only four patients presented dysphonia symptoms that remitted spontaneously. Conclusion The new zero-profile implant demonstrated good postoperative results, with a low dysphagia and dysphonia prevalence, and these were completely resolved in all the cases.