Outcomes After Operative Management of Combat-Related Low Lumbar Burst Fractures

Formby, Peter M.; Wagner, Scott C.; Pisano, Alfred J.; Blarcum, Gregory S. Van; Kang, Daniel G.; Lehman, Ronald A.

doi:10.1097/brs.0000000000001006

Cited by 6 publications

(6 citation statements)

References 20 publications

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“…Over 50% of spinal column fractures in their series of 32 patients consisted of low lumbar fractures, presumably because of military body armor transferring more force to the low lumbar spine. Another report by the same institution investigated 24 patients undergoing operative treatment for combat-related low lumbar fractures 18. In this series, 43% of patients had postoperative complications and 30% required acute reoperation.…”

Section: Discussionmentioning

confidence: 99%

Short-Segment Pedicle Fixation of Traumatic Low Lumbar Fractures (L3–L5)

Moawad

Arzi²,

Naik

et al. 2022

Clinical Spine Surgery: A Spine Publication

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Study Design: Prospective review. Objective: The aim was to assess the efficacy and safety of short-segment pedicle fixation of low lumbar fractures (L3–L5). Background: Low lumbar fractures are relatively uncommon, and limited data exists regarding the management of these injuries. No previous studies have specifically examined the surgical management of L3–L5 fractures exclusively with pedicle fixation. Materials and Methods: We reviewed prospectively collected data of 36 patients who underwent short-segment pedicle fixation for low lumbar fractures at our institution between 1993 and 2018. Results: There was no worsening of neurological status following surgery, and three patients regained motor or sphincter function. Thirty-one (86.1%) patients went on to successful fusion. Three (8%) patients required reoperation. Four (11%) patients had surgical complications. Conclusions: This large series provides information regarding the safety and efficacy of surgical management of low lumbar fractures with pedicle fixation. Following surgery, there was no neurological worsening and some patients regained neurological function. Low complication rates, low reoperation rates, and low pain levels at final follow-up provide evidence that the surgical management of low lumbar fractures utilizing short-segment pedicle fixation is safe and efficacious.

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Section: Discussionmentioning

confidence: 99%

Short-Segment Pedicle Fixation of Traumatic Low Lumbar Fractures (L3–L5)

Moawad

Arzi²,

Naik

et al. 2022

Clinical Spine Surgery: A Spine Publication

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“…A retrospective review of combat-related burst fractures engaged in the wars in Iraq and Afghanistan has collected 24 patients of low lumbar (L3-5) burst fractures. 39 Eleven patients had a neurological injury, 4 of which were complete.…”

Section: War and Combat Injuriesmentioning

confidence: 99%

Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

2021

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This review aims to search the epidemiology and incidence rates of thoracolumbar spine fractures. A systematic review of the literature of the last 10 years gave 586 results with “incidence,” and 387 results with “epidemiology,” of which 39 papers were analyzed. The review results were discussed and voted in 2 consensus meetings of the WFNS (World Federation of Neurosurgical Societies) Spine Committee. Out of 39 studies, 15 studies have focused on thoracolumbar trauma, remaining 24 studies have looked at all spine trauma. Most were retrospective in nature; few were prospective and multicenter. Some studies have focused on specific injuries. The annual incidence of TL fractures is about 30/100,000 inhabitants including osteoporotic fractures. There is a trend to increase the fractures in elderly population especially in developed countries, while an increase of motor vehicle accidents in developing countries. The mortality rate among male elderly patients is relatively high. The incidence of thoracolumbar spine fractures is increasing because of low-velocity falls in the elderly population. The main reasons are falls and traffic accidents. Learning the regional differences and some special forms of trauma such as extreme sports, war, and gunshot injuries will help the prevention of the thoracolumbar spine fractures.

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“…The authors believed that spine surgery in the battlefield hospitals was not beneficial for the recovery of neurological functions but instead increased the incidence of complications, including the need for a second surgery. Therefore, under general circumstances, it is not recommended to perform spine surgery in battlefield hospitals [51, 54].…”

Section: Early-phase Treatments Of Combat-related Spine Injuriesmentioning

confidence: 99%

Chinese expert consensus on the treatment of modern combat-related spinal injuries

et al. 2019

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The battlefield treatments of spinal and spinal cord injury vary from civilian settings. However, there is no unified battlefield treatment guidelines for spine trauma in PLA. An expert consensus is reached, based on spine trauma epidemiology and the concepts of battlefield treatment combined with the existing levels of military medical care in modern warfare. Since the specialized treatment for spine trauma are no significant difference between civilian settings and modern war, the first aid, emergency treatment and early treatment of spine trauma are introduced separately in three levels in this consensus. In Level I facilities, the fast and accurate evaluation of spine trauma followed by fixation and stabilization are recommended during the first-aid stage. Re-evaluation, further treatment for possible hemorrhagic shock, dyspnea and infection are recommended at Level II facilities. At Level III facilities, it is recommended to strengthen the intensive care and the prevention of urinary system and lung infection for the wounded with severe spinal injury, however, spinal surgery is not recommended in a battlefield hospital. The grading standard for evidence evaluation and recommendation was used to reach this expert consensus.

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Outcomes After Operative Management of Combat-Related Low Lumbar Burst Fractures

Abstract: 4.

Cited by 6 publications

References 20 publications

Short-Segment Pedicle Fixation of Traumatic Low Lumbar Fractures (L3–L5)

Short-Segment Pedicle Fixation of Traumatic Low Lumbar Fractures (L3–L5)

Incidence and Epidemiology of Thoracolumbar Spine Fractures: WFNS Spine Committee Recommendations

Chinese expert consensus on the treatment of modern combat-related spinal injuries

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