Successful Management by Posterior Approach Only of a Highly Comminuted L4 Fracture with 8 years of Follow-up: A Case Report.

Q4 Medicine JBJS case connector Pub Date : 2024-07-11 eCollection Date: 2024-07-01 DOI:10.2106/JBJS.CC.23.00643
Hossein Mehdian, Dritan Pasku, Elie Najjar, Nasir A Quraishi
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Abstract

Case: A 28-year old male patient was involved in a RTA and sustained a highly comminuted L4 burst fracture with more than 90% canal compromise.Considering the complete loss of power in the respective myotomes but the preservation of sacral sparing there were controversially different surgical options. We successfully performed a posterior only surgical procedure, which applied a modified transpedicle access technique to decompress the spinal canal and to restore the anterior column, achieving full neurological recovery at the final follow-up.

Conclusion: A well-planned and executed posterior surgery alone can achieve excellent clinical and radiological result in the treatment of severely comminuted lumbar fractures.

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仅从后方入路成功治疗高度粉碎性 L4 骨折,随访 8 年:病例报告。
病例:一名 28 岁的男性患者在一起 RTA 事故中遭受了高度粉碎性 L4 爆裂性骨折,椎管受损超过 90%。考虑到各肌节完全丧失动力,但仍需保留骶骨,因此存在不同的手术方案,这一点颇具争议。我们成功实施了仅后路手术,应用改良的经皮穿刺技术为椎管减压并恢复前柱,在最后的随访中实现了神经功能的完全恢复:结论:在治疗严重粉碎性腰椎骨折时,精心策划和实施的单纯后路手术可取得良好的临床和影像学效果。
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来源期刊
JBJS case connector
JBJS case connector Medicine-Medicine (all)
CiteScore
0.60
自引率
0.00%
发文量
319
期刊介绍: JBJS Case Connector helps improve patient care by providing the medical community with a journal that harnesses technology to provide information tools for discovery and reporting of unusual musculoskeletal problems, findings, treatment, and outcomes. Co-edited by Thomas W. Bauer, MD, PhD, and Ronald W. Lindsey, MD, JBJS Case Connector assists orthopaedic surgeons in the search for precedents, connections, and trends in their efforts to improve patient care. Using this unique journal, surgeons can find the commonalities between cases, benefit from the experience of their peers, and filter case information by many important variables in order to provide the best possible care for orthopaedic patients. This cross-referenced online journal includes thousands of orthopaedic case reports. It compiles symptoms, conditions, and demographic details to empower surgeons to find cases similar to theirs. Surgeons can mine the database to reveal emerging trends and identify patterns, distinguishing between truly rare cases and repeated, related single instances of a larger problem. The JBJS Case Connector Image Quiz feature provides interactive quizzes based on images from content published by JBJS and includes a discussion area for further exploration of ideas and concepts. The JBJS Image Quiz app for iPad and iPhone is available in the App Store. Contributions to JBJS Case Connector are welcomed from anywhere in the world and are considered on their merits. Articles must be written in English and should be submitted as outlined in the Instructions to Authors. All authors must abide by the JBJS ethics policies and all submissions to JBJS Case Connector are covered by the JBJS embargo policy.
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