Padalkar Pravin, Virani Nilesh, Kathare Ambadas
Center for Orthopaedics and Spine Surgery, 204A, Neel Enclave, Sec 9, Khanda Colony, New Panvel - 410206. India.; MGM Institute of Health Sciences, Sector 9, Kamothe Navi Mumbai. 410209. India.
MGM Institute of Health Sciences, Sector 9, Kamothe Navi Mumbai. 410209. India.
J Orthop Case Rep. 2014 Apr-Jun;4(2):5-9. doi: 10.13107/jocr.2250-0685.157.
A case of young male patients aged 25 years old presented with history of injured from falling heavy object on his back. There was burst Fracture of L5 Vertebrae with grade 3 spondylolisthesis. It was completely different from the types of L5 fracture that had been published up to now. Our patient had combination of a complete burst fracture of the fifth lumbar vertebra with dislocation and complete disruption of the posterior ligamantous and bony complex between L5 and sacrum. We would like to report this unique case of comminuted burst fracture of L5 with grade III spondylolisthesis treated with reconstruction of L5 body from transforaminol approach with the good results & significant neurological improvement till his six month follow up after the operation.
A case of young male patients aged 25 years old presented with history injured from falling heavy object on his back. The physical examination revealed contusion on his back Neurological examination confirmed complete paralysis of L5 and S1 root on both sides. Loss Bladder-bowel function, sphincter tone and peri-anal sensation. Plain radiograph of lumbar-sacral spine showed the anterior dislocation of L5-S1 spondylo-listhesis approximately 75%, with the complete comminuted burst fracture of L5 vertebra.
Anterior support and reconstruction of vertebral body is of immense importance in Lumbar burst fracture, When combined with posterior short segment fixation. This can be achieved with Usage of expandable cages when opted for posterior only approach. They obviate need of anterior approach for reconstruction of vertebral body.
一名25岁的年轻男性患者，有重物砸伤背部的病史。L5椎体爆裂骨折并伴有3级椎体滑脱。这与迄今为止已发表的L5骨折类型完全不同。我们的患者为第五腰椎完全爆裂骨折合并脱位，以及L5与骶骨之间的后韧带和骨复合体完全断裂。我们想报告这例独特的L5粉碎性爆裂骨折伴III级椎体滑脱病例，采用经椎间孔入路重建L5椎体进行治疗，术后六个月随访效果良好，神经功能有显著改善。
一名25岁的年轻男性患者，有重物砸伤背部的病史。体格检查发现其背部有挫伤。神经学检查证实双侧L5和S1神经根完全麻痹。大小便功能丧失、括约肌张力及肛周感觉丧失。腰骶椎X线平片显示L5-S1椎体滑脱约75%，L5椎体完全粉碎性爆裂骨折。
腰椎爆裂骨折时，椎体的前路支撑和重建与后路短节段固定相结合非常重要。若仅选择后路手术，可使用可扩张椎间融合器来实现，这样就无需前路椎体重建手术。
