- 期刊
- OpenAccess
Spinopelvic fixation using a commercially available pedicle screw as a salvage procedure for continuous L4 and L5 burst fractures: A case report
並列摘要
We report a rare case of a patient with continuous L4 and L5 burst fractures and his treatment course including the initial fixation, fixation failure, salvage procedure, and final outcome. A young man sustained continuous L4 and L5 burst fractures with the cauda equina syndrome after a fall from a 3 m height. His neurological deficit resolved after urgent posterior decompression and initial L2-S1 instrumentation. However, the S1 pedicle screws loosened, and the initial surgical construct failed during hospitalization. Spinopelvic fixation with commercially available pedicle screws instead of iliac screws was then performed as a salvage procedure. Serial radiographs were used to assess implant stability, fusion status, and spinal alignment over the next two years. The patient's neurological status gradually improved from Frankel A to Frankel E after salvage surgery and rehabilitation. Bony fusion was observed in 6 months on radiographs with adequate stability of the spinopelvic fixation. Continuous L4 and L5 burst fractures are a rare injury resulting in neurologic deficits and spinal instability requiring surgical treatment. Optimal instrumentation may require both pedicle and iliac screws two levels above and two levels below the injury for adequate fixation.
延伸閱讀
- Chin, C. M., & Tzeng, S. T. (2019). Pedicle subtraction osteotomy in lateral decubitus position to correct severe kyphosis in patient with ankylosing spondylitis-Case report. Formosan Journal of Musculoskeletal Disorders, 10(2), 69-73. https://doi.org/10.6492/FJMD.201905_10(2).0004
- Sengupta, D. K., & Herkowitz, H. N. (2012). Pedicle Screw-Based Posterior Dynamic Stabilization: Literature Review. Advances in Orthopedics, 2012(), 120-126. https://doi.org/10.1155/2012/424268
- Chen, Y. H., Sun, J. M., Chang, C. J., & Hsieh, C. T. (2017). Asymptomatic Bone Cement Leakage into Inferior Vena Cava during Cement Augmentation of Pedicle Screw for Osteoporotic Vertebral Collapse. 輔仁醫學期刊, 15(3), 153-159. https://doi.org/10.3966/181020932017091503004
- Chang, C. M., Yeh, K. T., Lee, R. P., Yu, T. C., Peng, C. H., Liu, K. L., Wang, J. H., Wu, W. T., & Chen, I. H. (2015). Medium-Term Follow-Up Outcomes of Anterior Debridement and Fusion Followed by Posterior Pedicle Screw Fixation in Pyogenic Spondylodiscitis. Formosan Journal of Musculoskeletal Disorders, (), 1-8. https://doi.org/10.6492/FJMD.20160304
- Chang, C. M., Yeh, K. T., Lee, R. P., Yu, T. C., Peng, C. H., Liu, K. L., Wang, J. H., Wu, W. T., & Chen, I. H. (2017). Medium-term follow-up outcomes of anterior debridement and fusion followed by posterior pedicle screw fixation in pyogenic spondylodiscitis. Formosan Journal of Musculoskeletal Disorders, 8(2), 75-82. https://doi.org/10.6492/FJMD.20160304