0
Articles   |    
Dural laceration occurring with burst fractures and associated laminar fractures

The Journal of Bone & Joint Surgery.  1989; 71:1044-1052 
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case
text A A A

Abstract

The cases of sixty patients in whom a burst fracture of a thoracic or lumbar vertebral body had been treated with posterior instrumentation and arthrodesis less than two weeks after the injury were retrospectively reviewed. Thirty of the patients had an associated laminar fracture. Eleven of the thirty, all of whom had a lumbar fracture and a preoperative neurological deficit, were noted at operation to have dural laceration. In four of the patients who had dural laceration, neural elements were entrapped between the fragments from the laminar fracture. None of the remaining thirty patients who did not have a laminar fracture had dural laceration (p = 0.0002). Univariate and multivariate statistical analysis revealed no significant association of the dural laceration with the patients' age or sex, or with the radiographic characteristics of the spine. There was a significant association between dural laceration and neurological deficit (p = 0.0001). In our series, the presence of a preoperative neurological deficit in a patient who had a burst fracture and an associated laminar fracture was a sensitive (100 per cent) and specific (74 per cent) predictor of dural laceration. The presence of this fracture pattern and an associated neurological deficit also predicted a risk of dural laceration with entrapped neural elements. This information may influence decisions as to whether an anterior or a posterior surgical approach should be used in such patients.

Figures in this Article
    This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.

    Topics

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe




    Related Articles
    Related Cases
    Related Content
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    jbjs jobs
    12/22/2011
    ME - Central Maine Medical Center
    12/22/2011
    VA - Charleston Area Medical Center
    12/22/2011
    Virginia - Charleston Area Medical Center