ABSTRACT
A clinical case of a patient with a triple unstable non contiguous thoracolumbar spine fracture, operated by the spine group of the Hospital del Trabajador is presented. A brief review of the literature is done concerning the epidemiology and management of these kind of injuries.
Se presenta el caso clínico de un paciente con una triple fractura inestable, no contigua, de la columna toraco-lumbar, operado por el equipo de columna del Hospital del Trabajador. Se hace una breve revisión de la literatura acerca de la epidemiología y el manejo de este tipo de lesiones.
Subject(s)
Humans , Male , Adult , Spinal Fractures/surgery , Spinal Fractures , Multiple Trauma/surgery , Multiple Trauma , Spinal Fusion , Lumbar Vertebrae/injuries , Thoracic Vertebrae/injuriesABSTRACT
STUDY DESIGN: A retrospective study. OBJECTIVES: To analyze the mode of injury, associated lesions, time of injury, and the checking times of MRI/CT and Bone scans in multiple spine fractures SUMMARY OF LITERATURE REVIEW: CT was predominantly used to discover and identify the fracture levels of the spine. However, fracture level identification in the entire spine was limited. CT, MRI and Bone scans were used for diagnosing multiple spine fractures. MATERIALS AND METHODS: Between 1999 and 2004, 12 patients who had more than level 3 spine fractures were studied. The mode of injury, associated lesions, time of injury, and checking times of MRI/CT and Bone scans were analyzed. RESULTS: The causes of the spinal injuries were from a fall from height, from traffic accidents and from multi-complex forced trauma in 7, 4 and 1 cases, respectively. Most cases had no severe associated lesions. The accuracy of the plain roentgenograms was 26% and that of CT was 35.3%, and the average checking time was 1.5 days. The accuracy of MRI was 100% and the average checking time was 4.3 days. The accuracy of the bone scans was 100%, and the average checking time was 11.7 days. The fracture patterns consisted of 37, 7, 3 and 3 non-compression (74%), compression (14%), burst (6%) and fracture-dislocation types (6%), respectively. The major treatment methods used with these patients were conservative. The treatment methods in 4 cases were with the use posterior instrumentation. CONCLUSIONS: MRI produced more accurate and faster results than the other methods of detection. The accuracy of the plain roentgenograms was 26%, which was relatively inaccurate. Therefore, if the patient complains of multiple back pains, the surgeon must check other diagnostic tools.
