Thoracolumbar Spine Trauma

Waddell, W. Hunter; Gupta, Rishabh; Stephens, Byron F.

doi:10.1016/j.ocl.2021.05.014

Cited by 9 publications

(7 citation statements)

References 64 publications

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“…Die Kyphoplastie zeigt bei Immobilisation oder starker Kyphosierung im Vergleich zu konservativer Therapie signifikant bessere Ergebnisse mit höherer Lebensqualität und geringerer Mortalität 10 . Bei höhergradiger Instabilität, starker Fehlstellung, Spinalkanalstenose oder Mehretagenfrakturen können eine dorsale Stabilisierung oder Korrekturspondy-lodese mittels Schrauben-Stab-Systemen nötig sein 21 .…”

Section: Interdisziplinäre Therapieansätze Wichtigunclassified

Eingebrochen – Osteoporotische Wirbelkörperfrakturen

Wilck¹,

Zahn²,

Steinmeier³

2023

physiopraxis

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Section: Interdisziplinäre Therapieansätze Wichtigunclassified

Eingebrochen – Osteoporotische Wirbelkörperfrakturen

Wilck¹,

Zahn²,

Steinmeier³

2023

physiopraxis

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“…Der Standard implantatbasierter Operationen bei Verletzungen der thorakolumbalen Wirbelsäule ist die dorsale Stabilisierung der Wirbelkörper mittels Schrauben-Stab-Systemen [ 7 ]. Eine Reposition und Stabilisierung der Verletzung erfolgt mit sogenannten pedikelschraubenbasierten Systemen.…”

Section: Operative Versorgungsstrategien Variierenunclassified

Gebrochener Körper – Nachbehandlung thorakolumbaler Wirbelkörperfrakturen

Zahn¹,

Steinmeier²,

Wilck³

2022

physiopraxis

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“…Оперативные вмешательства заканчивают обязательной реклинацией и репозицией травмированных позвоночно-двигательных сегментов (ПДС) для восстановления анатомо-физиологических параметров позвоночного столба и канала и создания надежного спондилодеза. Деком-прессия необходима для сохранения спинного мозга и спинномозговых нервов и создания условий для их восстановления [1][2][3][4]. По данным разных авторов, ПСМТ на грудном и поясничном уровнях у 7,7-64,0 % больных сопровождается разрывом ТМО, как правило, разрыв верифицируют на этапе ламинэктомии [5][6][7][8][9][10].…”

Section: Introductionunclassified

Treatment strategy for patients with thoracic and lumbar spine fractures with dura mater tear

Martikyan¹,

Грин

Talypov³

et al. 2022

Nejrohirurgiâ (Mosk.)

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Background. The dura mater tear are quite common in patients with thoracic and lumbar fractures. Prevention and management of cerebrospinal fluid leakage and sealing of the dura mater suture is an important stage in the treatment of such patients.Objective: to find an optimal surgical tactics for patients with fractures of the thoracic and lumbar spine and dura mater tear.Materials and methods. This study included 167 patients operated on for fractures of the thoracic and lumbar spine with concomitant traumatic spinal canal stenosis. We analyzed their clinical data and results of instrumental examination. All patients underwent laminectomy at the level of their fractures and transpedicular fixation. The main group included 55 patients with dura mater tear, whereas the control group comprised 112 patients without dura mater tear.Results. Dura mater tear was found in 32.9 % of patients with fractures of the thoracic and lumbar spine. Of them, 21.8 % had compression of the spinal cord or nerve roots at the sites of dura mater tear. This fact should be taken into account when performing decompression and the reduction maneuver to prevent additional injuries to the neural structures. Thirty-three (60.0 %) patients underwent direct suturing aimed to restore the dura mater integrity. Their mean size of the dura mater tear was 13.2 ± 7.4 mm2. Thirteen patients (23.6 %) with larger dural tear (27.5 ± 6.3 mm2) underwent their repair using either a fragment of dura mater from a deceased donor (n = 2), Reperen implants (n = 5), or Durepair patches (n = 6). In 9 patients (16.4 %), the integrity of dura mater was restored without suturing (the «sandwich»-sealing method) (mean size of the dura mater defect 5.0 ± 2.6 mm2). Twenty-one patients had additional sealing of dura mater suture using bioglue.Postoperative wound cerebrospinal fluid leakage was registered in 5 out of 55 patients from the main group. Cerebrospinal fluid leakage was most common in patients who had undergone dura mater repair with implants (23.1 %), while those who had undergone direct dura mater suturing were less likely to develop it (6.1 %). No cerebrospinal fluid leakage was observed in patients with small defects (≤3 mm2) or in those whose dural tears were located at the nerve root cuffs. Patients with postoperative cerebrospinal fluid leakage had no additional sealing of dura mater suture using bioglue.Postoperative wound infection was registered in 4 (7.3 %) patients from the main group and 6 (5.4 %) patients from the control group.Conclusion. Sealing of dura mater sutures with glue compositions is an effective method to prevent postoperative cerebrospinal fluid leakage. Sealing of dura mater sutures with a collagen sponge does not prevent wound cerebrospinal fluid leakage.

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Thoracolumbar Spine Trauma

Cited by 9 publications

References 64 publications

Eingebrochen – Osteoporotische Wirbelkörperfrakturen

Eingebrochen – Osteoporotische Wirbelkörperfrakturen

Gebrochener Körper – Nachbehandlung thorakolumbaler Wirbelkörperfrakturen

Treatment strategy for patients with thoracic and lumbar spine fractures with dura mater tear

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