Multilevel noncontiguous spinal fractures: Surgical approach towards clinical characteristics
Asian Spine Journal, cilt.9, sa.6, ss.889-894, 2015 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 9 Sayı: 6
- Basım Tarihi: 2015
- Doi Numarası: 10.4184/asj.2015.9.6.889
- Dergi Adı: Asian Spine Journal
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.889-894
- Anahtar Kelimeler: Spinal column, Spinal fracture, Multilevel, Surgery
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
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 ≥5 intact vertebrae between two fractured vertebral segments, each fracture region was managed with a separated stabilization. In cases with ≤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 ≤4 intact vertebra in between, stabilization of one segment should prompt the involvement of the secondary fracture into the system.