Bilgic Serkan, Kilincoglu Volkan, Kurklu Mustafa, Yurttas Yuksel, Ozkan Huseyin, Sehirlioglu Ali
Department of Orthopaedics, Gulhane Military Medical Academy Etlik, Ankara Turkey.
Cases J. 2009 Jun 24;2:6257. doi: 10.4076/1757-1626-2-6257.
The reason we report this case is that spine injuries may well occur due to landmines similar to other injuries like traumatic limb amputations and more over they may be overlooked.
The patient was 29-years-old Turkish male and was a member of the military. He detonated the landmine that caused his injuries while in a conflict zone. He had a right below knee and left above knee traumatic amputations. He had also mild intermittent pain in his lower back. There were no focal neurological findings such as weakness, altered sensibility, or alteration in the function of the bowel or bladder. Radiographs of the lumbar spine revealed an L2 burst fracture. Computed tomography scans and magnetic resonance imaging of the lumbar spine demonstrated a burst fracture of the L2 vertebrae and moderate compression in the anterior portion of the thecal sac due to the fracture fragment. Because of the stabile nature of the L2 burst fracture and lack of neurological disturbance, operative decompression, instrumentation and fusion was not performed. After healing of the stumps, the patient was mobilized with immediate prostheses and a thoracolumbosacral brace.
Spine injuries should not be overlooked when evaluating patients after landmine explosions. After the patient has been stabilized, the secondary screening and radiographic evaluations should also comprise the thoracic, thoracolumbar and lumbar spine when treating patients after landmine injuries.
我们报告该病例的原因是,脊柱损伤很可能像创伤性肢体截肢等其他损伤一样,由地雷爆炸导致,而且这类损伤可能被忽视。
患者为一名29岁的土耳其男性军人。他在冲突地区引爆了一枚导致其受伤的地雷。他的右下肢膝关节以下和左下肢膝关节以上遭受创伤性截肢。他的下背部还有轻度间歇性疼痛。未发现诸如无力、感觉改变或肠道或膀胱功能改变等局灶性神经学表现。腰椎X线片显示L2椎体爆裂骨折。腰椎计算机断层扫描和磁共振成像显示L2椎体爆裂骨折,骨折碎片导致硬脊膜囊前部中度受压。由于L2椎体爆裂骨折情况稳定且无神经功能障碍,未进行手术减压、器械固定和融合手术。残端愈合后,患者立即佩戴假肢并使用胸腰骶支具进行活动。
在评估地雷爆炸伤患者时,不应忽视脊柱损伤。在地雷伤患者治疗过程中,患者病情稳定后,二次筛查和影像学评估还应包括胸椎、胸腰椎和腰椎。