Journal of Trauma and Injury

Three-column reconstruction through the posterior approach alone for the treatment of a severe lumbar burst fracture: a case report: Woo Seok Kim, Tae Seok Jeong, Woo Kyung Kim; J Trauma Inj. 2023;36(3):290-294. Published online June 9, 2023; DOI: https://doi.org/10.20408/jti.2022.0075

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Abstract PDF: Generally, patients with severe burst fractures, instability, or neurological deficits require surgical treatment. In most cases, circumferential reconstruction is performed. Surgical methods for three-column reconstruction include anterior, lateral, and posterior approaches. In cases involving an anterior or lateral approach, collaboration with general or thoracic surgeons may be necessary because the adjacent anatomical structures are unfamiliar to spinal surgeons. Risks include vascular or lumbar plexus injuries and cage displacement, and in most cases, additional posterior fusion surgery is required. However, the posterior approach is the most common and anatomically familiar approach for surgeons performing spinal surgery. We present a case in which three-column reconstruction was performed using only the posterior approach to treat a patient with a severe lumbar burst fracture.; Summary

Penetrating sacral injury with a metallic pipe: a case report and literature review: Mahnjeong Ha, Kyoung Hyup Nam, Jae Hun Kim, In Ho Han; J Trauma Inj. 2022;35(2):131-138. Published online May 11, 2022; DOI: https://doi.org/10.20408/jti.2021.0063

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Abstract PDF: Other than gunshot injuries, sacral penetrating injuries with a foreign body exiting to the other side are extremely rare. We encountered a case of sacral injury in which a long metallic pipe penetrated from the anus into the lower back of a patient. Since the pelvis contains various organs, management of a penetrating injury requires multidisciplinary treatment involving several medical specialties. Due to the infrequency of this type of injury, there are no definitive guidelines for effective management. We described our experience surgically treating a sacral penetrating injury and conducted a literature review. On this basis, we suggest a surgical strategy for treating this type of injury.; Summary

Indirect Reduction and Spinal Canal Remodeling through Ligamentotaxis for Lumbar Burst Fracture: Wu Seong Kang, Jung Chul Kim, Ik Sun Choi, Sung Kyu Kim; J Trauma Inj. 2017;30(4):212-215. Published online December 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.4.212

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Abstract PDF: The choice of the most appropriate treatment for thoracolumbar or lumbar spine burst fracture remains controversial from conservative treatment to fusion through a posterior or anterior approach. There are many cases where ligamentotaxis is used to reduce the burst fracture. However, indirect reduction using ligamentotaxis is often limited in the magnitude of the reduction that it can achieve. In our patient with severe burst fracture, we were able to restore an almost normal level of vertebral height and secure spinal canal widening by using only ligamentotaxis by posterior instrumentation. Before the operation, the patient had more than 95% encroachment of the spinal canal. This was reduced to less than 10% after treatment.; Summary

The Value of X-ray Compared with Magnetic Resonance Imaging in the Diagnosis of Traumatic Vertebral Fractures: Yang Woo Lee, Jae Ho Jang, Jin Joo Kim, Yong Su Lim, Sung Youl Hyun, Hyuk Jun Yang; J Trauma Inj. 2017;30(4):158-165. Published online December 30, 2017; DOI: https://doi.org/10.20408/jti.2017.30.4.158

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Abstract PDF

Purpose

The purpose of this study was to evaluate the diagnostic accuracy of X-rays in patients with acute traumatic vertebral fractures visiting the emergency department and to analyze the diagnostic value of X-rays for each spine level.

Methods

We retrospectively analyzed basal characteristics by reviewing medical records of 363 patients with adult traumatic vertebral fractures, admitted to the emergency center from March 1, 2014 to February 28, 2017. We analyzed spine X-rays and magnetic resonance imaging (MRI) scans to determine distribution according to the vertebral level, and we evaluated the efficacy of X-rays by comparing discrepancies between X-rays and MRI scans.

Results

For a total of 363 patients, the mean age was 56.65 (20?93) and 214 (59%) were males. On the basis of X-rays, 67 cases (15.1%) were of the cervical spine, 133 cases (30.0%) were of the thoracic spine, and 243 cases (54.9%) were of the lumbar spine. In particular, the thoracolumbar region (T11-L2) was the most common, with 260 cases (58.7%). In X-rays, fractures were the least in the upper thoracic region (T1-T3), whereas MRI scans revealed fairly uniform distribution across the thoracic spine. Sensitivity of X-rays was lowest in the upper thoracic spine and specificity was almost always greater than 98%, except for 94.7% in L1. Positive predictive value was lower in the mid-thoracic region (T4-T9) and negative predictive value was slightly lower in C6, T2, and T3 than at other sites. Diagnostic accuracy of X-rays by vertebral body, transverse process, and spinous process according to fractured vertebral structures was significantly different according to vertebral level.

Conclusions

Diagnostic accuracy of X-rays was lower in the upper thoracic region than in other parts. Further studies are needed to identify better methods for diagnosis considering cost and neurological prognosis.

Summary

Citations

Citations to this article as recorded by

A novel radiological assessment to identify acute vertebral compression fractures: A pilot observational study
Keisuke Tsuruta, Toru Ueyama, Tomoo Watanabe, Yasunori Kobata, Kenichi Nakano, Hidetada Fukushima
Acute Medicine & Surgery.2023;[Epub] CrossRef
Forward Bending in Supine Test: Diagnostic Accuracy for Acute Vertebral Fragility Fracture
Chan-Woo Jung, Jeongik Lee, Dae-Woong Ham, Hyun Kang, Dong-Gune Chang, Youngbae B. Kim, Young-Joon Ahn, Joo Hyun Shim, Kwang-Sup Song
Healthcare.2022; 10(7): 1215. CrossRef

A Blunt Traumatic Vertebral Artery Injury: A Case Report: Min A Lee, Kang Kook Choi, Gil Jae Lee, Byung Chul Yu, Dae Sung Ma, Yang Bin Jeon, Min Chung, Jung Nam Lee; J Trauma Inj. 2016;29(1):28-32. Published online March 31, 2016; DOI: https://doi.org/10.20408/jti.2016.29.1.28

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Abstract PDF

Blunt traumatic vertebral artery injury (TVAI) is relatively rare, but it may frequently be associated with head and neck trauma. TVAI is difficult to diagnose with diverse outcomes, thus it is a clinical challenge. There are no widely accepted guidelines for treatment and diagnosis, so that the diagnosis of TVAI can be easily delayed. Therefore, any clinical suspicion from clues on the initial imaging is important for diagnosis of TVAI. The authors report on the case of a patient diagnosed as having a TVAI with a transverse foramen fracture.

Summary

Citations

Citations to this article as recorded by

Airway management in a displaced comminuted fracture of the mandible and atlas with a vertebral artery injury: A case report
Rathna Paramaswamy
Journal of Dental Anesthesia and Pain Medicine.2018; 18(3): 183. CrossRef

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