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Spinal Stabilization Using Orthopedic Extremity Instrumentation Sets During Operation Enduring Freedom-Afghanistan.

Vijay M Ravindra1, Scott A Wallace2, Rahul Vaidya3

  • 1Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA.

World Neurosurgery
|September 23, 2015
PubMed
Summary

Orthopedic extremity instrumentation successfully stabilized unstable lumbar spine fractures in a combat zone. This off-label use demonstrated construct stability, though it is not recommended for standard medical practice.

Keywords:
FractureHardwareLumbarOrthopedic extremity instrumentation setSpine

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Area of Science:

  • Orthopedic surgery
  • Combat casualty care
  • Spinal fusion techniques

Background:

  • Role III, Multinational Medical Unit in Kandahar provided combat casualty care during Operation Enduring Freedom-Afghanistan.
  • Treatment of unstable lumbar spine fractures was performed between January 2007–January 2008 and November 2010–May 2011.

Purpose of the Study:

  • To describe the experience of treating unstable lumbar spine fractures using orthopedic extremity instrumentation sets.
  • To evaluate the efficacy and safety of using non-spinal instrumentation for spinal stabilization in a resource-scarce combat environment.

Main Methods:

  • 15 patients with unstable lumbar spine fractures underwent surgical treatment.
  • Procedures included anterior corpectomy and instrumented fusion (n=5) or posterior instrumented fusion (n=10).
  • Orthopedic extremity instrumentation sets were utilized due to scarcity of dedicated spinal sets.

Main Results:

  • Postoperative radiographs showed no fracture progression or hardware failure.
  • One patient exhibited stable spinal construct at 4-week follow-up.

Conclusions:

  • Unstable spine fractures can potentially be treated with non-spinal instrumentation in austere combat settings.
  • This represents an off-label use and is not recommended as standard practice in most medical environments.