Miyakoshi Naohisa, Maekawa Shigeto, Urayama Masakazu, Shimada Yoichi
Department of Orthopedic Surgery, Akita University Graduate School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan.
Department of Orthopedic Surgery, Ogachi Central Hospital, 25 Yamada-Yugaoka, Yuzawa 012-0055, Japan.
Case Rep Orthop. 2018 Jun 10;2018:8185051. doi: 10.1155/2018/8185051. eCollection 2018.
Spinal flexion-distraction injuries (FDIs) are unstable fractures, commonly located at the thoracolumbar junction. Management of FDIs often necessitates the use of posterior instrumentation and fusion, but long-segment instrumentation surgery decreases postoperative spinal mobility and increases the risk of junctional kyphosis and fracture. We report the case of a patient with FDI showing an L2 vertebral fracture, unilateral L2 pedicle fracture, and disruptions of the posterior ligamentous complex between L1 and L2. After open reduction using L1 and L2 pedicle screws with a conventional trajectory on the right side, a cortical bone trajectory (CBT) pedicle screw was used as an osteosynthesis screw for the fractured left pedicle. This procedure enabled successful single-level fusion. Follow-up radiological examination revealed good reduction and complete bone union. To the best of our knowledge, utilizing a CBT technique as an osteosynthesis screw in FDIs has not previously been described.
脊柱屈伸分离性损伤（FDIs）是不稳定骨折，常见于胸腰段交界处。FDIs的治疗通常需要使用后路内固定和融合术，但长节段内固定手术会降低术后脊柱活动度，并增加交界性后凸和骨折的风险。我们报告一例FDI患者，其表现为L2椎体骨折、单侧L2椎弓根骨折以及L1和L2之间的后韧带复合体损伤。在右侧采用传统轨迹的L1和L2椎弓根螺钉进行切开复位后，使用皮质骨轨迹（CBT）椎弓根螺钉作为骨折的左侧椎弓根的内固定螺钉。该手术成功实现了单节段融合。随访影像学检查显示复位良好且骨完全愈合。据我们所知，此前尚未有在FDIs中使用CBT技术作为内固定螺钉的相关描述。
