Traumatic Fracture of the Thoracic Spine With Severe Posterolateral Dislocation: A Case Report

Zygogiannis, Konstantinos; Manolakos, Konstantinos; Kalampokis, Anastasios; Thivaios, Georgios C.; Moschos, Savvas

doi:10.7759/cureus.23830

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…[10,29,30] Five (38.5%) were from India, and one (7.7%) was from Korea, Japan, Greece, Iran, and Turkey each. [1,3,9,[12][13][14]16,22,28,32] Cases from Iran, Korea, India, Turkey, and USA described their approach to the dural defect. [7,9,[12][13][14]16,22,30,31] Repair of durotomy e dura was deemed nonrepairable and therefore not repaired in two (20%) of the 20 cases.…”

Section: Systematic Review Search Resultsmentioning

confidence: 99%

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Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection

Vazquez,

Houten,

Stadlan

et al. 2023

Surgical Neurology International

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Background: Traumatic spondyloptosis (TS) with complete spinal cord transection and unrepairable durotomy is particularly rare and can lead to a difficult-to-manage cerebrospinal fluid (CSF) leak. Methods: We performed a systematic review of the literature on TS and discuss the management strategies and outcomes of TS with cord transection and significant dural tear. We also report a novel case of a 26-year-old female who presented with thoracic TS with complete spinal cord transection and unrepairable durotomy with high-flow CSF leak. Results: Of 93 articles that resulted in the search query, 13 described cases of TS with complete cord transection. The approach to dural repair was only described in 8 (n = 20) of the 13 articles. The dura was not repaired in two (20%) of the cases. Ligation of the proximal end of the dural defect was done in 15 (75%) of the cases, all at the same institution. One (5%) case report describes ligation of the distal end; one (5%) case describes the repair of the dura with duraplasty; and another (5%) case describes repair using muscle graft to partially reconstruct the defect. Conclusion: Suture ligation of the thecal sac in the setting of traumatic complete spinal cord transection with significant dural disruption has been described in the international literature and is a safe and successful technique to prevent complications associated with persisting high-flow CSF leakage. To the best of our knowledge, this is the first report of thecal sac ligation of the proximal end of the defect from the United States.

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Section: Systematic Review Search Resultsmentioning

confidence: 99%

“…[ 10 , 29 , 30 ] Five (38.5%) were from India, and one (7.7%) was from Korea, Japan, Greece, Iran, and Turkey each. [ 1 , 3 , 9 , 12 - 14 , 16 , 22 , 28 , 32 ] Cases from Iran, Korea, India, Turkey, and USA described their approach to the dural defect. [ 7 , 9 , 12 - 14 , 16 , 22 , 30 , 31 ]…”

Section: Systematic Reviewmentioning

confidence: 99%

Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection

Vazquez,

Houten,

Stadlan

et al. 2023

Surgical Neurology International

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“…A recent study by Lee et al [4] reported the case of a 37-year-old man with a T3-4 posterior dislocation resulting in complete paraplegia. Patients were treated with controlled sequential sagittal distraction and unlocking anteroposterior shear reversal, and open reduction using horizontally aligned temporary rods to facilitate alignment restoration [17].…”

Section: A a B B C C D D A A B B C C D Dmentioning

confidence: 99%

Partial Vertebrectomy in Neglected Spondyloptosis at the T10–11 Level: A Case Report

Priambodo,

Dahlan,

Ompusunggu

2024

J Minim Invasive Spine Surg Tech

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Our objective was to document the surgical results from a case and conduct a retrospective analysis of partial vertebrectomy in neglected spondyloptosis at the T10–11 level. Traumatic spondyloptosis is a severe and rare spinal cord injury. In spondyloptosis, there is a traumatic subluxation of adjacent vertebral bodies that exceeds the normal anatomical limits. The thoracic vertebrae possess a rigid skeleton, and the sternum also contributes to maintaining stability in the upper-middle chest area. Therefore, instances of spondyloptosis in the thoracic spine are exceedingly rare. Thoracic spondyloptosis typically results in neurological deficits. A 45-year-old man presented to the neurosurgery outpatient clinic complaining of weakness of lower extremities, back pain, headache, and vomiting. The patient was hospitalized for 7 days, and he was diagnosed with neglected spondyloptosis based on a computed tomography scan. The patient was treated using laminectomy decompression, bilateral facetectomy, partial vertebrectomy, and posterior stabilization. Management in cases of spondyloptosis has the aim of reduction, alignment, and stabilization. Early surgery with reduction and rigid stabilization is preferable to conservative treatment in most cases. The surgical approach can be anterior, posterior, or combined, without significant differences. Vertebrectomy is performed to remove part of the vertebral body to reduce spinal cord pressure. Thoracic spondyloptosis is a very rare but severe type of spinal cord injury. Neurological deficits are common in patients with this condition. Early management involving reduction and stabilization is generally recommended to obtain a better outcome.

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Traumatic Fracture of the Thoracic Spine With Severe Posterolateral Dislocation: A Case Report

Cited by 2 publications

References 17 publications

Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection

Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection

Partial Vertebrectomy in Neglected Spondyloptosis at the T10–11 Level: A Case Report

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