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Complex multilevel lumbar spine fractures with transverse sacral fracture

We report an unusual and complex case of spinal trauma in a 17-year-old boy who presented with a transverse sacral fracture associated with multiple-level lumbar fractures, paraparesis, and bladder involvement. A two-stage surgery was performed. The lumbar spine fractures were treated with posterior...

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Autores principales: Chaudhary, Kshitij, Potdar, Prabodhan, Bapat, Mihir
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227367/
https://www.ncbi.nlm.nih.gov/pubmed/22144756
http://dx.doi.org/10.4103/0019-5413.87143
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author Chaudhary, Kshitij
Potdar, Prabodhan
Bapat, Mihir
author_facet Chaudhary, Kshitij
Potdar, Prabodhan
Bapat, Mihir
author_sort Chaudhary, Kshitij
collection PubMed
description We report an unusual and complex case of spinal trauma in a 17-year-old boy who presented with a transverse sacral fracture associated with multiple-level lumbar fractures, paraparesis, and bladder involvement. A two-stage surgery was performed. The lumbar spine fractures were treated with posterior instrumented correction of displacements, followed by anterior instrumentation and fusion. The sacral fracture was left untreated. At 5-year followup, the patient had complete neurological recovery except for the right L5 root function. The long-segment lumbar fusion and the untreated displaced sacral fracture contributed to spinal imbalance, due to which the patient is now able to stand only in a crouched posture. Determining the optimal treatment for the case is presented due to the relative rarity of transverse sacral fracture and paucity of evidence-based treatment approaches. In patients with associated lumbar spine fractures that require extension of instrumentation to the upper lumbar spine, it is critical to restore sacropelvic alignment to achieve spinal balance. Adequate reduction of sacropelvic anatomy can be achieved with iliac screw fixation.
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spelling pubmed-32273672011-12-05 Complex multilevel lumbar spine fractures with transverse sacral fracture Chaudhary, Kshitij Potdar, Prabodhan Bapat, Mihir Indian J Orthop Case Report We report an unusual and complex case of spinal trauma in a 17-year-old boy who presented with a transverse sacral fracture associated with multiple-level lumbar fractures, paraparesis, and bladder involvement. A two-stage surgery was performed. The lumbar spine fractures were treated with posterior instrumented correction of displacements, followed by anterior instrumentation and fusion. The sacral fracture was left untreated. At 5-year followup, the patient had complete neurological recovery except for the right L5 root function. The long-segment lumbar fusion and the untreated displaced sacral fracture contributed to spinal imbalance, due to which the patient is now able to stand only in a crouched posture. Determining the optimal treatment for the case is presented due to the relative rarity of transverse sacral fracture and paucity of evidence-based treatment approaches. In patients with associated lumbar spine fractures that require extension of instrumentation to the upper lumbar spine, it is critical to restore sacropelvic alignment to achieve spinal balance. Adequate reduction of sacropelvic anatomy can be achieved with iliac screw fixation. Medknow Publications & Media Pvt Ltd 2011 /pmc/articles/PMC3227367/ /pubmed/22144756 http://dx.doi.org/10.4103/0019-5413.87143 Text en Copyright: © Indian Journal of Orthopaedics http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Chaudhary, Kshitij
Potdar, Prabodhan
Bapat, Mihir
Complex multilevel lumbar spine fractures with transverse sacral fracture
title Complex multilevel lumbar spine fractures with transverse sacral fracture
title_full Complex multilevel lumbar spine fractures with transverse sacral fracture
title_fullStr Complex multilevel lumbar spine fractures with transverse sacral fracture
title_full_unstemmed Complex multilevel lumbar spine fractures with transverse sacral fracture
title_short Complex multilevel lumbar spine fractures with transverse sacral fracture
title_sort complex multilevel lumbar spine fractures with transverse sacral fracture
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227367/
https://www.ncbi.nlm.nih.gov/pubmed/22144756
http://dx.doi.org/10.4103/0019-5413.87143
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