Jarin Ian J, Samocha Yigal, Houten John K, Kinon Merritt D
Departments of Orthopedic Surgery, Westchester Medical Center, Valhalla, New York.
Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, New York.
J Neurosurg Case Lessons. 2024 Oct 21;8(17). doi: 10.3171/CASE24455.
Traumatic dural lacerations can be caused by thoracolumbar burst fractures and, infrequently, can be associated with the entrapment of neural elements within a laminar fracture. The diagnosis of both is difficult to make on preoperative imaging, as the conditions are typically appreciated during surgical exploration. The authors present a case of traumatic durotomy with entrapment of neural elements in a laminar fracture that they believed could be appreciated on preoperative magnetic resonance imaging (MRI).
A young male involved in a motor vehicle collision presented to the authors' trauma center with a lumbar burst and laminar fracture. Preoperative MRI demonstrated epidural hemorrhage and entrapment of neural elements within the laminar fracture, which was confirmed intraoperatively. The patient underwent a successful decompression, release of nerve roots, fusion, and recovery.
Traumatic durotomy and entrapment of neural elements can occur after a traumatic spinal fracture, and a diagnosis made upon preoperative MRI can allow for effective preoperative planning. Clinicians should have a high index of suspicion for these pathologies when encountering certain fracture patterns and could therefore tailor the surgical approach to avoid further neurological injury during surgery. https://thejns.org/doi/10.3171/CASE24455.
创伤性硬脑膜撕裂可由胸腰椎爆裂骨折引起，且很少与椎板骨折内神经结构的嵌顿相关。这两种情况在术前影像学检查中均难以诊断，因为通常在手术探查时才能明确病情。作者报告了一例创伤性硬脑膜切开术合并椎板骨折内神经结构嵌顿的病例，他们认为术前磁共振成像（MRI）可以发现该情况。
一名因机动车碰撞受伤的年轻男性被送至作者所在的创伤中心，诊断为腰椎爆裂骨折和椎板骨折。术前MRI显示硬膜外出血和椎板骨折内神经结构嵌顿，术中得到证实。患者成功接受了减压、神经根松解、融合手术并康复。
创伤性脊柱骨折后可发生创伤性硬脑膜切开术和神经结构嵌顿，术前MRI诊断有助于进行有效的术前规划。临床医生在遇到某些骨折类型时，应高度怀疑这些病变，从而调整手术方式以避免手术中进一步的神经损伤。https://thejns.org/doi/10.3171/CASE24455
