Noncontiguous Unstable Spine Fractures

Wittenberg, R. H.; Hargus, Stefan; Steffen, R.; Muhr, G.; Bötel, U

doi:10.1097/00007632-200202010-00010

Cited by 36 publications

(30 citation statements)

References 17 publications

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“…There was a mean of 2.8 days to 52.6 days delay in diagnosis of the secondary lesion [10,17]. Sometimes, the second injury is not recognised early enough to prevent clinically significant extension of the neurological deficit, pain pattern, spinal instability and deformity [13].…”

Section: Discussionmentioning

confidence: 99%

“…Noncontiguous spinal fractures are a rare and special type of multilevel spinal injuries, most frequently occurring in a fall from height or a traffic accident [17]. A delayed diagnosis of the second lesion is frequently seen in the literature, ranging from 23.1% to even up to 83.3% [13,15,17].…”

Section: Introductionmentioning

confidence: 99%

“…A delayed diagnosis of the second lesion is frequently seen in the literature, ranging from 23.1% to even up to 83.3% [13,15,17]. The definition of these injuries is not clear in the literature, resulting in variable incidence from 1.6% to 23.8% [6,10].…”

Section: Introductionmentioning

confidence: 99%

“…The optimal approach to the management of these patients has yet to be identified [17]. The purpose of this study is to evaluate the outcomes of three treatments for multilevel noncontiguous spinal fractures; and compare the therapeutic effect.…”

Section: Introductionmentioning

confidence: 99%

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The treatment for multilevel noncontiguous spinal fractures

Lian

Zhao

Hou

et al. 2006

International Orthopaedics (SICO

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We report the outcome of 30 patients with multilevel noncontiguous spinal fractures treated between 2000 and 2005. Ten cases were treated conservatively (group A), eight cases were operated on at only one level (group B), and 12 cases were treated surgically at both levels (group C). All cases were followed up for 14-60 months (mean 32 months). Initial mobilisation with a wheelchair or crutches in group A was 9.2±1.1 weeks, which was significantly longer than groups B and C with 6.8±0.7 weeks and 3.1±0.4 weeks, respectively. Operative time and blood loss in group C were significantly more than group B. The neurological deficit improved in six cases in group A (60%), six in group B (75%) and eight in group C (80%). Correction of kyphotic deformity was significantly superior in groups C and B at the operated level, and increasing deformity occurred in groups A and B at the non-operated level. From the results we believe that three treatment strategies were suitable for multilevel noncontiguous spinal fractures, and individualised treatment should be used in these patients. In the patients treated surgically, the clinical and radiographic outcomes are much better.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The treatment for multilevel noncontiguous spinal fractures

Lian

Zhao

Hou

et al. 2006

International Orthopaedics (SICO

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“…These injuries usually occur at a single level. 7,13 Although double-level lateral lumbar dislocation was reported by a few authors, 14,15 to our knowledge, the presence of lateral lumbar dislocations in double noncontiguous lesions has not been reported.…”

Section: Introductionmentioning

confidence: 88%

Two-level traumatic lateral lumbar fracture and dislocation in a heavy equipment operator: a case report

Nakao¹,

Kajino

2013

Journal of Chiropractic Medicine

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Objective: Lumbar fracture-dislocations are rare and invariably due to high-energy trauma. The purpose of this study is to report the surgical management of a man with lateral lumbar dislocations in 2 noncontiguous lesions. Clinical features: A 49-year-old Asian man was crushed by a bulldozer. The patient was transported to a major medical center where he was found to be conscious, and the primary spinal injuries were fracture-dislocation of L1-L2 and L4-L5. His preoperative neurologic status showed a partial paraparesis to all motor groups of the lower extremities bilaterally. His radiological and operative findings showed a rupture of the thoracolumbar fascia and latissimus dorsi muscle, left L1-L2 dislocated facet, right L4-5 facet fracture, and dural tear. Intervention and outcome: The patient underwent a posterior reduction, decompression, instrumentation, and fusion surgery from T12 to S1 with autologous bone graft and pedicle screw instrumentation. Postoperatively, his neurologic status improved, allowing him to be ambulatory using a Lofstrand crutch with improved lumbosacral alignment being well maintained. Two weeks postoperatively, the patient regained voluntary bowel and bladder function. At the 1-year follow-up evaluation, his motor power was full in the left leg; however, sensation to pin prick remained lost on the right L5 and S1 distributions. He continued to ambulate using a Lofstrand crutch. Conclusion: Lateral lumbar fracture-dislocation at 2 noncontiguous levels is an unusual injury that results from high-energy trauma. Prompt recognition of the injuries, reduction of the fracture-dislocations, and posterior stabilization are recommended for neural decompression, spinal alignment, and long-term stabilization.

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