Multilevel Noncontiguous Spinal Fractures: Surgical Approach towards Clinical Characteristics
Asian Spine Journal
;
: 889-894, 2015.
Article
in English
| WPRIM
| ID: wpr-126912
ABSTRACT
STUDY DESIGN:
The study retrospectively investigated 15 cases with multilevel noncontiguous spinal fractures (MNSF).PURPOSE:
To clarify the evaluation of true diagnosis and to plane the surgical treatment. OVERVIEW OF LITERATURE MNSF are defined as fractures of the vertebral column at more than one level. High-energy injuries caused MNSF, with an incidence ranging from 1.6% to 16.7%. MNSF may be misdiagnosed due to lack of detailed neurological and radiological examinations.METHODS:
Patients with metabolic, rheumatologic diseases and neoplasms were excluded. Despite the presence of a spinal fracture associated clearly with the clinical picture, all patients were scanned within spinal column by direct X-rays, computed tomography and magnetic resonance imaging. When there were > or =5 intact vertebrae between two fractured vertebral segments, each fracture region was managed with a separated stabilization. In cases with < or =4 intact segments between two fractured levels, both fractures were fixed with the same rod and screw system.RESULTS:
There were 32 vertebra fractures in 15 patients. Eleven (73.3%) patients were male and age ranged from 20 to 64 years (35.9+/-13.7 years). Eleven cases were the American Spinal Injury Association (ASIA) E, 3 were ASIA A, and one was ASIA D. Ten of the 15 (66.7%) patients returned to previous social status without additional deficit or morbidity. The remaining 5 (33.3%) patients had mild or moderate improvement after surgery.CONCLUSIONS:
The spinal column should always be scanned to rule out a secondary or tertiary vertebra fracture in vertebral fractures associated with high-energy trauma. In MNSF, each fracture should be separately evaluated for decision of surgery and planned approach needs particular care. In MNSF with < or =4 intact vertebra in between, stabilization of one segment should prompt the involvement of the secondary fracture into the system.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Asia
/
Spinal Injuries
/
Spine
/
Magnetic Resonance Imaging
/
Incidence
/
Retrospective Studies
/
Spinal Fractures
/
Diagnosis
Type of study:
Diagnostic study
/
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
/
Male
Country/Region as subject:
Asia
Language:
English
Journal:
Asian Spine Journal
Year:
2015
Type:
Article
Similar
MEDLINE
...
LILACS
LIS