Total vertebrectomy and spine shortening for the treatment of T12-L1 spine dislocation: Management with suboptimal resources
Neurocirugia (Astur : Engl Ed). 2018 Nov-Dec;29(6):304-308.
doi: 10.1016/j.neucir.2018.03.001.
Epub 2018 Apr 22.
[Article in
English,
Spanish]
Affiliations
- 1 Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España. Electronic address: alejandro.lorentegomez@gmail.com.
- 2 Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Madrid Norte Sanchinarro, Madrid, España.
- 3 Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España.
- 4 Instituto Universitario de Investigación en Enfermedades Músculo-Esqueléticas, Valencia, España.
- 5 Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Infanta Cristina, Badajoz, España.
Abstract
Total vertebrectomy with spine shortening has been reported for the treatment of difficult cases of traumatic spine dislocation, both in acute and chronic phase. We report an exceptional case of a five-week-old T12-L1 spine dislocation in a 25-year-old female with complete paraplegia as a result of trauma in Ciudad de León (Nicaragua). In view of the time since the dislocation, we performed a complete L1 vertebrectomy in order to reduce the dorsolumbar hinge. For osteosynthesis material we had only eight screws and two Steffee plates. We therefore introduced pedicle screws at levels T11, T12, L2 and L3 on the right side and T11, T12, L3 and L4 on the left, and performed manual reduction of the spine. Steffee plates were placed and we added sublaminar wires to reinforce the osteosynthesis. Fifteen months after surgery, there has been no neurological improvement.
Keywords:
Acortamiento vertebral; Luxación vertebral; Spine shortening; Trauma; Traumatismo; Vertebral dislocation; Vertebrectomy; Vertebrectomía.
Copyright © 2018 Sociedad Española de Neurocirugía. Publicado por Elsevier España, S.L.U. All rights reserved.
MeSH terms
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Accidents, Traffic
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Adult
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Bone Plates
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Bone Screws / supply & distribution
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Bone Wires
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Developing Countries
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Female
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Fracture Dislocation / complications
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Fracture Dislocation / surgery*
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Fracture Fixation, Internal / instrumentation
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Fracture Fixation, Internal / methods*
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Humans
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Lumbar Vertebrae / surgery*
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Nicaragua
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Osteotomy / methods*
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Paraplegia / etiology
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Spinal Cord Injuries / etiology
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Spinal Fractures / complications
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Spinal Fractures / surgery*
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Thoracic Vertebrae / surgery*