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Acta Chir Belg 2022 Apr 8:1-4. Epub 2022 Apr 8.

Department of Surgery, Zuyderland Medical Center, Heerlen, The Netherlands.

Background: Manubriosternal dislocations are a rare entity and frequently associated with thoracic spine fractures and, in minority of cases, with cervical or thoracolumbar fractures.

Methods: Our case represents a 38-year-old male who fell from a height resulting in multiple fractures, amongst others of the first lumbar vertebra. At primary survey and computed tomography scan no manubriosternal injury was apparent. Read More

JBJS Case Connect 2022 02 16;12(1). Epub 2022 Feb 16.

Kothari Medical Centre, Kolkata, India.

Case: A 45-year-old man presented with posttraumatic fracture-dislocation of T11/12 with neurological level T8 AIS A. Sensory level progressed to T4 in the next day morning. He underwent T10, T11, T12, and L1 percutaneous pedicle screw-rod fixation. Read More

Medicine (Baltimore) 2021 Aug;100(34):e27021

Faculty of Biology and Biotechnology, University of Warmia and Mazury, Olsztyn, Poland.

Introduction: Osteogenesis imperfecta (OI) is a disorder of the connective tissue that mainly causes the bones to become excessively brittle. The vast majority of OI cases are associated with mutations in the genes encoding the I alpha.

Patient Concerns: A 57-year-old woman office worker was admitted because of severe, long-lasting pain in the thoracic spine while bending down. Read More

Chin J Traumatol 2021 Nov 6;24(6):397-400. Epub 2021 Jul 6.

North Haven, Connecticut, 06473, USA. Electronic address:

We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients' diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. Read More

Clin Neurol Neurosurg 2021 08 8;207:106744. Epub 2021 Jun 8.

Department of Orthopaedics, Changzheng Hospital, Second Military Medical University, Shanghai 200003, China. Electronic address:

Cervical spine fracture-dislocation in patients with ankylosing spondylitis (AS) and severe thoracic kyphosis is extremely unstable. This study was performed to investigate the efficacy and safety of halo vest application before and during surgery for these patients. We retrospectively analyzed the case histories, operations, neurologic outcomes, follow-up data, and imaging records of 25 patients with AS and severe thoracic kyphosis who underwent surgical treatment of cervical fracture-dislocation in our department from 2008 to 2019. Read More

Medicine (Baltimore) 2021 Apr;100(13):e25334

Department of Pediatric Surgery, University Children's Hospital Basel, University of Basel, Switzerland.

Abstract: Cervical spine (C-spine) fractures in young children are very rare, and little information on treatment modalities and functional, radiographic, and patient-reported outcome exists. In this 2-center, retrospective case series, we assessed subjective and functional mid-term outcomes in children aged ≤5 years whose C-spine fractures were treated nonoperatively.Between 2000 and 2018, 6 children (median age at injury: 23. Read More

Medicine (Baltimore) 2021 Jan;100(2):e24096

Department of Orthopaedic Surgery, Seoul Spine Institute, Sanggyepaik Hospital, College of Medicine, Inje University, Seoul, Korea.

Rationale: We report the first case of the management of spinal cord transection due to thoracolumbar fracture-dislocation in human beings. There are several case reports of cord transection, but only radiological findings have been reported; we report intraoperative findings and management.

Patient Concerns: A 53-year-old man presented to the hospital after falling. Read More

Orthop Traumatol Surg Res 2020 Nov 12;106(7):1245-1249. Epub 2020 Oct 12.

Société française de chirurgie rachidienne (SFCR), Société française d'orthopedie pédiatrique (SOFOP), 56, rue Boissonade, 75014 Paris, France.

Introduction: Epidemiological studies of fractures of the spine in children are all old, mostly single-centre, with series spanning periods of 5 to 20 years.

Hypothesis: As lifestyle is constantly changing, notably with an increase in sports activities and improvements in the prevention of road and household accidents, epidemiology has likely changed.

Objective: To update the description of spinal trauma in children and adolescents compared to the existing literature. Read More

Spinal Cord Ser Cases 2020 08 24;6(1):80. Epub 2020 Aug 24.

Department of Surgery, King Abdul-aziz Medical City, Riyadh, Saudi Arabia.

Introduction: The treatment of thoracic spine fracture-dislocations is now well established with the recent progress in spine surgery. Although most affected individuals have a degree of spinal cord injury (SCI), early surgical reduction, and stabilization of the unstable deformity allow an immediate program of rehabilitation. Vertebrectomy is considered as the last surgical technique reserved for the most persistent spinal deformities that cannot be brought to an acceptable correction with less invasive methods. Read More

BMJ Case Rep 2020 Aug 18;13(8). Epub 2020 Aug 18.

Trauma Surgery, Amsterdam UMC, Amsterdam, The Netherlands.

Rib fractures due to blunt trauma are a common chest injury seen at the emergency department; however, injuries to the costovertebral joints are very rare. We present a case of a 24-year-old man who was admitted after a high-speed car collision and was assessed in a level 1 trauma centre in Amsterdam. He had multiple injuries, including dislocation of the costovertebral joint of ribs 7-10. Read More

Spinal Cord Ser Cases 2020 07 29;6(1):67. Epub 2020 Jul 29.

Central Institute of Orthopaedics (CIO), VMMC & Safdarjung Hospital, Delhi, 110029, India.

Introduction: We report two cases of fracture-dislocation of the thoracolumbar spine without neurological deficit and outline the putative mechanisms responsible for the escape of neural tissues from injurious forces and the surgical management strategies for this type of injury. We also review similar cases described in the literature.

Case Reports: A 24-year-old female with post-traumatic fracture dislocation at the T10-T11 level without neurological deficit, along with a right femoral shaft fracture, was managed with laminectomy of T10-T11 levels with bilateral facetectomy and transpedicular screws and with an intramedullary interlocking nail for the femur fracture. Read More

Surg Neurol Int 2020 13;11:150. Epub 2020 Jun 13.

Departments of Neurosurgery, Augusta University Hospital, Augusta, Georgia, United States.

Background: Thoracic spine fracture-dislocations due to motor vehicle accidents (MVAs) rarely involve double- level, noncontiguous lesions.

Case Description: A 19-year-old male following an MVA was paraplegic; he exhibited full motor/sensory loss below the T4 level (i.e. Read More

Spine (Phila Pa 1976) 2020 Jul;45(13):884-894

Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea.

Study Design: Retrospective case analyses.

Objective: The aim of this study was to investigate the incidence and characteristics of associated upper cervical spine injuries in 15 survival cases of traumatic atlanto-occipital dislocation (AOD).

Summary Of Background Data: Traumatic AOD is a rare and generally fatal injury. Read More

J Back Musculoskelet Rehabil 2020 ;33(3):437-442

Background: It is important to evaluate clinical efficacy and safety of posterior internal fixation using pedicle screw system.

Objectives: To investigate clinical characteristics of patients diagnosed with fracture-dislocation of the thoracic spine with or without minimal spinal cord.

Methods: Twenty-eight patients with fracture-dislocation of thoracic spine with or without minimal spinal cord injury were retrospectively analyzed. Read More

BMC Surg 2019 Jul 29;19(1):101. Epub 2019 Jul 29.

Department of Spine Surgery, Ningbo No.6 Hospital, No.1059, Zhongshan East Road, Ningbo, China.

Background: Spine fractures combined with sternal injury are most commonly occur in the thoracic region. Lower cervical and thoracolumbar injuries have also been reported, especially for the patients with manubriosternal dislocation. The type of spine injury is easily recognized in initial presentation, but we may miss the sternal fracture and manubriosternal dislocation. Read More

Spinal Cord Ser Cases 2019 14;5:19. Epub 2019 Feb 14.

Grady Health System, Emory Department of Neurosurgery, Grady Memorial Hospital, 80 Jesse Hill Jr. Dr. SE, Atlanta, GA, 30303, USA.

Introduction: Charcot spinal arthropathy (CSA) is an uncommon clinical entity following spinal cord injury (SCI). It is characterized by progressive cartilaginous and bony destruction and is felt to be due to loss of proprioceptive and nociceptive feedback from the spine. CSA is typically diagnosed many years following SCI and has the potential to lead to progressive neurologic decline if left untreated. Read More

Zh Vopr Neirokhir Im N N Burdenko 2019 ;83(2):66-70

Research Clinical Center of JSC Russian Railways, Moscow, Russia.

According to statistical studies in different countries, the annual incidence of spine and spinal cord injuries is 15-50 cases per 1 million people. In Russia, the incidence of this condition is 5% of the total number of all nonpenetrating traumatic injuries (Neurosurgery: Guidelines for Physicians, ed. by Prof. Read More

Epilepsia 2019 05 25;60(5):996-1004. Epub 2019 Apr 25.

Medical Intensive Care Units, University Hospital Basel, Basel, Switzerland.

Objective: We present a systematic review of the literature regarding types and anatomic distribution of fractures in association with generalized convulsive status epilepticus (GCSE) and convulsive seizures in adult patients accompanied by an illustrative case of a patient with GCSE and diffuse postictal pain from underlying bone fractures.

Methods: The library search engines PubMed and EMBASE were screened systematically using predefined search terms. All identified articles written in English were screened for eligibility by two reviewers. Read More

J Med Case Rep 2019 Feb 26;13(1):44. Epub 2019 Feb 26.

Division of General Anaesthesiology, Emergency and Intensive Care Medicine, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria.

Background: Atlanto-occipital dislocation is a rare and severe injury of the upper spine associated with a very poor prognosis.

Case Presentation: We report the case of a 59-year-old European man who suffered from out-of-hospital cardiac arrest following a motor vehicle accident. Cardiopulmonary resuscitation was initiated immediately by bystanders and continued by emergency medical services. Read More

Traffic Inj Prev 2019 4;20(1):84-92. Epub 2019 Feb 4.

d Nationwide Children's Center for Injury Research and Policy , Columbus , Ohio.

Objective: Motor vehicle occupants aged 8 to 12 years are in transition, in terms of both restraint use (booster seat or vehicle belt) and anatomical development. Rear-seated occupants in this age group are more likely to be inappropriately restrained than other age groups, increasing their vulnerability to spinal injury. The skeletal anatomy of an 8- to 12-year-old child is also in developmental transition, resulting in spinal injury patterns that are unique to this age group. Read More

J Spinal Cord Med 2020 01 21;43(1):3-9. Epub 2018 May 21.

Department of Orthopaedic Surgery and Neurosurgery at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.

It is well established that traumatic spinal dislocations (AO Type C injuries) should be surgically treated. However, no recent comparative study of surgical versus non-surgical management of type C injuries was found attesting the superiority of surgical treatment. Due to the lack of information about the natural history of non-surgical management of type C injuries, we evaluated the outcome of historical conservative treatment of type C injuries. Read More

Neurocirugia (Astur : Engl Ed) 2018 Nov - Dec;29(6):304-308. Epub 2018 Apr 22.

Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Infanta Cristina, Badajoz, España.

Total vertebrectomy with spine shortening has been reported for the treatment of difficult cases of traumatic spine dislocation, both in acute and chronic phase. We report an exceptional case of a five-week-old T12-L1 spine dislocation in a 25-year-old female with complete paraplegia as a result of trauma in Ciudad de León (Nicaragua). In view of the time since the dislocation, we performed a complete L1 vertebrectomy in order to reduce the dorsolumbar hinge. Read More

World Neurosurg 2018 Jun 15;114:375-380. Epub 2018 Mar 15.

Department of Neurosurgery, Preah Kossamak Hospital, Phnom Penh, Cambodia; Department of Global Health and Social Medicine, Harvard Medical School, Boston, Massachusetts, USA.

Objective: In recent years, delivery of cost-effective "essential neurosurgery" in resource-limited communities has been recognized as an indispensable part of health care and a global health priority. The aim of this study was to review outcomes from operative management of spine trauma at a resource-limited government hospital in Phnom Penh, Cambodia, and to provide an epidemiologic report to guide prevention programs.

Methods: A retrospective review of a prospective neurosurgical database was performed to identify risk factors for spine trauma and severe spinal cord injury (American Spinal Injury Association A or American Spinal Injury Association B) and to evaluate the cost-effectiveness of surgery for patients treated at Preah Kossamak Hospital for subaxial and thoracolumbar spine trauma from 2013 to 2016. Read More

Medicine (Baltimore) 2018 Mar;97(9):e0050

Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

Rationale: Traumatic fracture of the thoracolumbar junction (T10-L2) is the most common fracture of the spinal column. Due to the disruption of the entire vertebrae column, the fracture-dislocation of the thoracolumbar spine is almost invariably associated with neurological injury. A complete fracture-dislocation of the thoracolumbar spine without neurological deficit is a rare entity. Read More

World Neurosurg 2018 May 7;113:e166-e171. Epub 2018 Feb 7.

Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.

Objective: To apprise readers about this rare but severest form of traumatic spine injury and its surgical management.

Background: Complete fracture dislocation and subluxation (>100%) of 1 vertebral body in the coronal or sagittal plane with respect to the adjacent vertebra is defined as spondyloptosis. In coronal spondyloptosis the subluxated vertebral bodies lie beside each other, and the condition is lateraloptosis. Read More

J Spinal Cord Med 2019 07 7;42(4):416-422. Epub 2018 Feb 7.

c Department of Orthopaedic Surgery and Neurosurgery at Thomas Jefferson University , Philadelphia , Pennsylvania , USA.

Context: Current treatment of TLST should consider injury morphology, neurological status, clinical status (pain and disability) and also multimodal radiological evaluation (MMRE) with CT, MRI and dynamic/ standing plain radiographs.

Methods: A narrative literature review was performed to propose a treatment algorithm to guide the management of thoracolumbar spinal trauma (TLST). In order to classify injuries and surgical indications, we utilized the two most recent classification systems (TLICS and new AO spine classification) and related recent literature. Read More

Spine (Phila Pa 1976) 2018 07;43(13):E734-E739

Department of Orthopedics, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.

Study Design: A randomized, double-blind, placebo-controlled clinical trial.

Objective: To evaluate the efficacy and safety of tranexamic acid (TXA) administered during the surgical correction of thoracolumbar fracture-dislocation.

Summary Of Background Data: Thoracolumbar fracture-dislocation surgery is generally associated with substantial blood loss and a high risk of deep vein thrombosis. Read More

Spine J 2018 06 23;18(6):1005-1013. Epub 2017 Oct 23.

Department of Radiology, Campus Bio-Medico University, Via A. del Portillo 21, 00100 Rome, Italy.

Background Context: The load sharing classification (LSC) laid foundations for a scoring system able to indicate which thoracolumbar fractures, after short-segment posterior-only fixations, would need longer instrumentations or additional anterior supports.

Purpose: We analyzed surgically treated thoracolumbar fractures, quantifying the vertebral body's fragment displacement with the aim of identifying a new parameter that could predict the posterior-only construct failure.

Study Design: This is a retrospective cohort study from a single institution. Read More

ANZ J Surg 2019 05 20;89(5):E212-E213. Epub 2017 Oct 20.

Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia.

Orthop Nurs 2017 Sep/Oct;36(5):350-355

Chen Zhao, MS, The Second Affiliated Hospital of Xi'an Medical University, Baqiao District, Xi'an, Shaanxi Province, China Bing Zhang, BS, The Second Affiliated Hospital of Xi'an Medical University, Baqiao District, Xi'an, Shaanxi Province, China. Jiandang Shi, MD, General Hospital of Ningxia Medical University, Xingqing District, Victory Street, Yinchuan City, Ningxia Province, China. Yaping Li, BS, General Hospital of Ningxia Medical University, Xingqing District, Victory Street, Yinchuan City, Ningxia Province, China. Long Pang, MD, General Hospital of Ningxia Medical University, Xingqing District, Victory Street, Yinchuan City, Ningxia Province, China.

Fractures and dislocations with complete lateral displacement of the spine at the lumbar and thoracic levels are some of the most severe types of thoracolumbar trauma. They are usually caused by high-energy trauma and accompanied by extreme, life-threatening injuries and neurological deficits that vary in severity, which may delay operative intervention. It is often difficult to reduce such a complex fracture-dislocation because of the force that the muscles exert on the bone and the injured part of the spinal cord. Read More