Rainone Gersham J, Patel Yash, Woodhouse Cody, Sauber Ryan, Yu Alexander
Medicine, Drexel University College of Medicine, Philadelphia, USA.
Neurosurgery, Allegheny General Hospital, Pittsburgh, USA.
Cureus. 2022 Sep 23;14(9):e29492. doi: 10.7759/cureus.29492. eCollection 2022 Sep.
Thoracolumbar fractures are a common consequence of trauma, often a result of motor vehicle accidents or falls. Burst fractures are a morphology of thoracolumbar fracture in which compressive force causes retropulsion of the posterior elements of the vertebral body, potentially leading to neurological deficits. The Thoracolumbar Injury Classification and Severity (TLICS) score is a decision-making tool to help surgeons decide between nonoperative and operative management. For assigned scores of 4, management is at the discretion of the surgeon, and for scores ≥ 5, operative treatment is recommended. Burst fracture patients that are neurologically intact are given a score of 5 if there is a posterior ligamentous complex (PLC) injury and are recommended to undergo operative management. Here we present a neurologically intact patient with an L4 burst fracture with PLC injury that was managed conservatively and demonstrated successful clinical, functional, and radiographic recovery.
胸腰椎骨折是创伤的常见后果，通常由机动车事故或跌倒所致。爆裂骨折是胸腰椎骨折的一种形态，其中压缩力导致椎体后部结构向后移位，可能导致神经功能缺损。胸腰椎损伤分类和严重程度（TLICS）评分是一种决策工具，可帮助外科医生在非手术和手术治疗之间做出决定。对于评分为4分的患者，治疗由外科医生自行决定，对于评分≥5分的患者，建议进行手术治疗。神经功能完整的爆裂骨折患者，如果存在后韧带复合体（PLC）损伤，则评分为5分，建议接受手术治疗。在此，我们报告一例神经功能完整的L4爆裂骨折伴PLC损伤患者，该患者接受了保守治疗，并取得了成功的临床、功能和影像学恢复。
