Department of Orthopaedic Surgery (NOCERAL), Universiti Malaya, Faculty of Medicine, Kuala Lumpur, Malaysia.
Acta Orthop Traumatol Turc. 2024 Aug 2;58(4):244-246. doi: 10.5152/j.aott.2024.23137.
The incidence of traumatic spine fractures (TSF) is increasing worldwide, with a reported annual incidence of up to 32.8 per 100000 persons. However, there are only a few cases of spine fractures reported in adolescent idiopathic scoliosis (AIS) patients after posterior spinal fusion (PSF) in the literature. Fractures adjacent to fusion blocks that extend into the lower lumbar spine pose a unique challenge as stabilization of such fractures might require an extension of instrumentation to L5 or the pelvis. We report a novel surgical technique where bilateral pedicle and cortical screws at L4 and supplementary rods that connect the cortical screws to the main rods via dominos were implemented for optimizing the distal anchorage for TSF stabilization following an L3 Chance fracture in an AIS patient who had undergone T4-L2 posterior spinal fusion.
外伤性脊柱骨折(TSF)的发病率在全球范围内呈上升趋势,据报道,其年发病率高达每 10 万人 32.8 例。然而,文献中仅报道了少数几例青少年特发性脊柱侧凸(AIS)患者在接受后路脊柱融合(PSF)后发生脊柱骨折的病例。融合块延伸至下腰椎的脊柱骨折具有独特的挑战性,因为此类骨折的稳定可能需要将器械延长至 L5 或骨盆。我们报告了一种新的手术技术,在接受 T4-L2 后路脊柱融合的 AIS 患者发生 L3 Chance 骨折后,在 L4 双侧椎弓根和皮质螺钉,并通过多米诺骨牌将皮质螺钉与主杆连接的附加杆,用于优化 TSF 稳定的远端锚固。