Diário da Espinha

What do we have to do with Traumatic Thoracolumbar Fractured and Lateral Dislocated Patients without Neurological Deficit?

Abstract

Tevfik Yılmaz, Onur Yaman, Nail Ozdemir, Ismail Ertan Sevin, Omer Akar and Sedat Dalbayrak

Thoracolumbar fracture-dislocations usually cause complete neurological dysfunction under the level of trauma. However, a few patients may not have neurological deficits. It’s thought to be responsible for the mechanism of spinal trauma. Aim of surgical treatment is to restore biomechanical stability. In this study we present three traumatic thoracolumbar fracture and lateral dislocation cases without neurological deficit. Both cases had a grade E according to Frankel scale and got 6 points according to Thoracolumbar Injury Classification Severity Scale (TLICS). Patients were treated with long-segment posterior instrumentation via posterior approach. Fracture-dislocation were reducted and stabilized succesfully with posteriror long-segment stabilization via posterior approach. We followed the first patient for 8 months and second patient for 4 years and the third patient for 3 months. Secondary kyphosis deformity didn’t develope in any patients during the follow up. Posterior long-segment stabilization is a safe and efficient treatment for thoracolumbar fracture-dislocation. There has been concern whether the stand-alone posterior surgery can prevent secondary kyphosis deformity in mid-term or long-term follow up or not.