Saratov JOURNAL of Medical and Scientific Research

Surgical management of thoracolumbar fracture-dislocation (clinical case)

Year: 2020, volume 16 Issue: №2 Pages: 488-494
Heading: Traumatology and Orthopedics Article type: Case report
Authors: Likhachev S.V., Zaretskov V.V., Ivanov D.V., Shulga A.E., Arsenievich V.B., Stepukhovich S.V., Mizyurov S.A.
Organization: Saratov National Research University n.a. N. G. Chernyshevsky, Saratov State Medical University

The article presents a clinical case history of successful two-stage surgical reconstruction of a rare injury — a simple thoracolumbar fracture-dislocation (Type С AOSpine classification). The optimal arrangement of the stabilizing system at the stage of surgical intervention planning was designed using computer biomechanical simulation. The functional outcome was optimal ensuring complete reconstruction of the lost anatomy with no complication in post-operative period observed.

1. Spiegl UJ, Josten C, Devitt BM, et al. Incomplete burst fractures of the thoracolumbar spine: a review of literature. Eur. Spine J 2017; 26 (12): 3187-98. DOI: 10.1007/S00586-017-5126-3.
2. Wood KB, Li W, Lebl DR, et al. Management of thoracolumbar spine fractures. Spine J 2014; 14 (1): 145-64. DOI:10.1016/j. spinee. 2012.10.041
3. Knop C, Bastian L, Lange U, et al. Complications in surgical treatment of thoracolumbar injuries. Eur Spine J 2002; (11): 214-26.
4. Joaquim AF, Ghizoni E, Tedeschi H, et al. Clinical Results of Patients with Thoracolumbar Spine Trauma Treated According to the Thoracolumbar Injury Classification System and Severity Score. J NeurosurgSpine 2014; 20 (5): 562-7. DOI: 10.3171/2014.2. SPINE121114.
5. Feng Z, Xiaoqing C, Xiangdong C, et al. Surgery for severe thoracolumbar fracture dislocation via a posterior approach. J Clin Neurosci 2015; 22 (12): 1954-8. DOI: 10.1016/j. jocn. 2015.04.029.
6. Chokshi JJ, Shah M. Outcomes of Including Fracture Level in Short-Segment Fixation for Thoracolumbar Fracture Dislocation. Asian Spine J 2019; 13 (1): 56-60. DOI: 10.31616/asj. 2018.0064.
7. Hao D, Wang W, Duan K, et al. Two-year follow-up evaluation of surgical treatment for thoracolumbar fracture-dislocation. Spine (Phila Pa 1976)2014; 39 (21): E1284-90. DOI: 10.1097/BRS. 0000000000000529.
8. Akay KM, Baysefer A, Kayali H, et al. Thoracolumbar Injury Classification Fracture and lateral dislocation of the T12-L1 vertebrae without neurological deficit — case report. Neurol Med Chir (Tokyo) 2003; (43): 267-70.
9. Phadnis AS, Tan CJ, Raman AS, et al. Fracture and complete dislocation of the spine with a normal motor neurology. Injury Extra 2006; (37): 479-83. DOI: 10.1016/j. injury. 2006.06.112.
10. Hsieh CT, Chen GJ, Wu CC, et al. Complete fracture-dislocation of the thoracolumbar spine without paraplegia. Am J Emerg Med 2008; (26): 633. e5-7. DOI: 10.1016/j. ajem. 2007.09.023.
11. Evans LJ. Images in clinical medicine. Thoracolumbar fracture with preservation of neurologic function. N Engl J Med 2012; (367): 1939. DOI: 10.1056/NEJMicm1101495.
12. Enishi T, Katoh S, Sogo T. Surgical treatment for significant fracturedislocation of the thoracic or lumbar spine without neurologic deficit: a case series. J Orthop Case Rep 2014; (4): 43-5. DOI: 10.13107/jocr. 2250-0685.194.
13. Rahimizadeh A, Asgari N, Rahimizadeh A. Complete thoracolumbar fracture-dislocation with intact neurologic function: explanation of a novel cord saving mechanism. J Spinal Cord Med 2017; (26): 1-10. DOI: 10.1080/10790268.2017.1336300.
14. Sugiura K, Sakai T, Adachi K, et al. Complete Fracture-Dislocation of the Thoracolumbar Spine with No Critical Neurological Deficit: A Case Report. J Med Invest 2016; 63 (1 -2): 122-6. DOI: 10.2152/jmi. 63.122.
15. Zeng J, Gong Q, Liu H, et al. Complete fracture-dislocation of the thoracolumbar spine without neurological deficit: A case report and review of the literature. Medicine (Baltimore) 2018; 97 (9): e0050. DOI: 10.1097/MD. 0000000000010050.
16. Su Y, Wang X, Ren D, et al. A finite element study on posterior short segment fixation combined with unilateral fixation using pedicle screws for stable thoracolumbar fracture. Medicine (Baltimore) 2018; 97 (34): 1-7. DOI: 10.1097/MD. 0000000000012046.
17. Donnik AM, Kirillova IV, Kossovich LYu, et al. Biomechanical modeling of reconstructive intervention on the thoracolumbar transition. AIP Conf. Proc 8th Polyakhov's Reading. 8th Polyakhov's Read. Proc. Int. Sci. Conf. Mech. 2018: 90-102. DOI: 10.1063/1.5034741.
18. Lima LVPC, Charles YP, Rouch P, et al. Limiting interpedicular screw displacement increases shear forces in screws: A finite element study. Orthop Traumatol Surg Res 2017; (103): 721-6. DOI: 10.1016/j. otsr. 2017.05.004.
19. Likhachev SV, Zaretskov VV, Arsenievich VB, et al. Optimization of transpedicular spondylosynthesis application for type A3 lesions of the thoracolumbar transition: clinical experimental study. Saratov Journal of Medical Scientific Research 2019; 15 (2): 275-83.
20. Couvertier М, Germaneau A, Saget М, et al. Biomechanical analysis of the thoracolumbar spine under physiological loadings: Experimental motion data corridors for validation of finite element models. Proc Inst Mech Eng Part H J Eng Med 2017; 231 (10): 975-81.

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