Management of Siginificant Fracture Dislocation of Thoracolumbar Spine with combined Anterior and Posterior Approach.
Dr. Tetsuya Enishi. Department of Orthopedics, Institute of Health Biosciences, The University of Tokushima Graduate School, 3-18-15 Kuramoto, Tokushima 770-8503, Japan. Ph: +81 88 633 7240. E-mail: enishi.tetsuya@tokushima-u.ac.jp
Introduction: Fracture-dislocation of the thoracic or lumbar spine often results in severe neurologic deficits if dislocation is significant. However, cases of fracture-dislocation of the thoracic or lumbar spine without neurologic deficits are rarely reported in the literature, and the choice of the treatment has been controversial.
Case Report: Two female patients, aged 27 and 35 years, were injured in motor vehicle accidents and did not have neurological deficits except for slight numbness in the thighs in one case. Radiologic examinations showed nearly complete fracture-dislocations at T7-8 and L1-2, respectively. In both cases, subtotal corpectomies and anterior reconstructions using Kaneda devices were performed after laminectomy in the lateral decubitus position. No neurological deterioration was observed after surgery.
Conclusion: Anterior subtotal corpectomy and reconstruction combined with posterior decompression is a good option for these cases to restore the alignment and the stability of the spine.
Keywords: Fracture-dislocation, Anterior decompression and reconstruction, Neurologic deficit.



