Thoracic Fracture-Dislocations Without Spinal Cord Injury - Two Cases Reports -

Dong Eun Shin; Seung Yong Rhee; Hak Sun Kim

doi:10.4184/jkss.2006.13.1.69

Journal List > J Korean Soc Spine Surg > v.13(1) > 1035751

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Shin, Rhee, and Kim: Thoracic Fracture-Dislocations Without Spinal Cord Injury - Two Cases Reports -

Original Article

Journal of Korean Spine Surg 2006;13(1):69-74.

Published online: 12 February 2006

DOI: https://doi.org/10.4184/jkss.2006.13.1.69

Thoracic Fracture-Dislocations Without Spinal Cord Injury - Two Cases Reports -

Dong Eun Shin, M.D., Seung Yong Rhee, M.D., Hak Sun Kim, M.D.^#

Department of Orthopaedic Surgery, Bundang CHA Hospital, College of Medicine, Yonsei University, Korea

^#Pochon CHA University, Yonsei University, Korea

Address reprint requests to Hak Sun Kim, M.D. Department of Orthopaedic Surgery, Youngdong Severance Hospital, Yonsei University College of Medicine #146-92 Dogok-dong, Gangnam-gu, Seoul, Korea Tel: 82-2-2019-3411, Fax: 82-2-573-5393, E-mail: haksunkim@yumc.yonsei.ac.kr

^∗ 본 논문의 요지는 2005년도 대한척추외과학회 춘계학술대회에서 발표되었음.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Thoracic fracturedislocations reportedly lead to an 80% incidence of complete paraplegia. Thus, thoracic fracturedislocations without cord injury are uncommon. There are a few cases of thoracic fracturedislocations in which the neural sparing status was associated with separation of the posterior spinal structures, such as the pedicles and laminae. The authors experienced two cases of thoracic fracturedislocations without spinal cord injury: one was a 50-year-old man who fell from the fourth floor of a building and sustained a T6- 7 fracturedislocation; and the other was a 43- year-old man who was involved in motorcycle accident and sustained a T12 fracturedislocation. Segmental spinal instrumentation and fusion without open reduction was performed in each of the two cases and there has not been any abnormality detected on neurological examination at a minimum follow- up period of 2 years.

Keywords: Thoracic fracturedislocation, Segmental spinal instrumentation and fusion, Neural sparing

REFERENCES

1). Bohler L. Die Technik der Knochenbruchbehandlung im Frieden und im Kriege. 1:9th-11th ed.Maudrich;Berlin: 1943.

2). Bohlman H, Freehafer A, Dejak J. The results of treatment of acute injuries of the upper thoracic paralysis. J Bone Joint Surg. 1985; 67:360–369.

3). Burke DC. Hyperextension injuries of the spine. J Bone Joint Surg. 1971; 53:3–12.

4). Dekutoki M, Conlan S, Salciccioli G. Spinal mobility and deformity after Harrington rod stabilization and limited arthrodesis of thoracolumbar fracture. J Bone Joint Surg. 1993; 75:168–176.

5). Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983; 8:817–831.

6). Denis F, Burkas JK. Shear fracture-dislocation of the thoracic and lumbar spine associated with forceful hyperextension (lumberjack paraplegia). Spine. 1992; 17:156–161.

7). Hanley E, Eskay M. Thoracic spine fracture. Orthopedics. 1989; 12:689–696.

8). Holdsworth F. Fractures, dislocations, and fracture-dislocations of the spine. J Bone Joint Surg. 1970; 52:1534–1551.

9). Liljenqvist U, Halm H, Castro W, et al. Thoracic fracture-dislocation without spinal cord injury: a case report and literature review. Europ Spine J. 1995; 4:252–256.

10). Magerl F, Aebi M, Gertzbein S, et al. A comprehensive classification of thoracic and lumbar injuries. Europ Spine J. 1994; 3:184–201.

11). Miyasaka Y, Satomi K, Sugihara S, et al. Post er ior fracture-dislocation of the thoracic spine without neurologic deficit. A case report and short literature review. Spine. 1993; 18:2351–2354.

12). Roaf R. A study of the mechanics of spinal injuries. J Bone Joint Surg. 1960; 42:810–823.

13). Shapiro S, Abel T, Rodgers RB. Traumatic thoracic spinal fracture dislocation with minimal or no cord injury. Report of four cases and review of the literature. J Neurosurg(Spine 3). 2002; 96:333–337.

Fig. 1.

Anteroposterior and lateral radiographs showing fracture-dislocation of T6/T7.

Fig. 2.

Preoperative CT scans and MR images showing translational displacement of the body of T6, shearing off the neural arch with bilateral pedicle fracture.

Fig. 3.

Postoperative anteroposterior and lateral radiographs after a posterior fusion (T5-T10) and anterior fusion(T5-T7, arrow).

Fig. 4.

Anteroposterior and lateral radiographs showing fracture-dislocation of T12.

Fig. 5.

Preoperative CT scans and MR images of T12 show translational separation of T12 vertebral body.

Fig. 6.

Postoperative anteroposterior and lateral radiographs after posterior and anterior fusion.

TOOLS

Similar articles