Lorente Alejandro, Palacios Pablo, Burgos Jesús, Barrios Carlos, Lorente Rafael
Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España.
Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Madrid Norte Sanchinarro, Madrid, España.
Neurocirugia (Engl Ed). 2018 Nov-Dec;29(6):304-308. doi: 10.1016/j.neucir.2018.03.001. Epub 2018 Apr 22.
Total vertebrectomy with spine shortening has been reported for the treatment of difficult cases of traumatic spine dislocation, both in acute and chronic phase. We report an exceptional case of a five-week-old T12-L1 spine dislocation in a 25-year-old female with complete paraplegia as a result of trauma in Ciudad de León (Nicaragua). In view of the time since the dislocation, we performed a complete L1 vertebrectomy in order to reduce the dorsolumbar hinge. For osteosynthesis material we had only eight screws and two Steffee plates. We therefore introduced pedicle screws at levels T11, T12, L2 and L3 on the right side and T11, T12, L3 and L4 on the left, and performed manual reduction of the spine. Steffee plates were placed and we added sublaminar wires to reinforce the osteosynthesis. Fifteen months after surgery, there has been no neurological improvement.
据报道，全椎骨切除术联合脊柱缩短术可用于治疗急慢性创伤性脊柱脱位的疑难病例。我们报告了一例特殊病例，一名25岁女性，在尼加拉瓜莱昂市因创伤导致T12-L1脊柱脱位五周，完全性截瘫。鉴于脱位后的时间，我们进行了L1椎体全切术以减少胸腰段铰链。用于骨固定的材料仅有八枚螺钉和两块Steffee钢板。因此，我们在右侧T11、T12、L2和L3以及左侧T11、T12、L3和L4置入椎弓根螺钉，并对脊柱进行了手动复位。放置了Steffee钢板，并添加了椎板下钢丝以加强骨固定。术后15个月，神经功能未改善。
