RESUMO
BACKGROUND: Hyperextension thoracic spine fractures (HTSFs) typically involve the anterior ligamentous complex of the spine. These patients often present with paraplegia and warrant early surgical reduction/fixation even though few deficits resolve. Here, we present the unusual case of a 40-year-old male whose paraparetic deficit resolved following reduction/fixation of a T7-T8 HTSF. CASE DESCRIPTION: A 40-year-old male presented with a thoracic computed tomography (CT) documented T7- T8 HTSF following a motor vehicle accident. His neurological examination revealed severe paraparesis, but without a sensory level (ASIA motor score 78). The chest CT angiogram scan revealed a hypodensity in the aorta, representing a small traumatic aortic dissection responsible for the patient's right hemothorax; 450 ml of blood was removed on chest tube placement. He underwent urgent/emergent thoracic spine reduction and fixation at the T7-T8 level. Within 5 postoperative months, he recovered fully neurological function (ASIA motor score 100). CONCLUSION: We recommend urgent/emergent surgical reduction/stabilization for patients with thoracic HTSF to decrease offer the potential for neurological recovery and avoid secondary injury due to continued compression.
RESUMO
Spinal penetrating trauma has a complex neurosurgical management. This study presents a 55-year-old male admitted in our center with a 1 × 1 centimeter laceration on the sacral area skin due to a wooden penetrating object. The computed tomography (CT) of the spine revealed a hypodense penetrating object that was introduced from the posterior aspect of the sacrum into dural space and then stopped in the S1 vertebral body. We performed a laminectomy of intact superior portion of the S1 lamina and released the wood from the surrounding bone, and finally, we pulled it out.
