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Related Experiment Videos

Concomitant noncontiguous thoracolumbar and sacral fractures

T J Albert1, M J Levine, H S An

  • 1Department of Orthopaedic Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania.

Spine
|August 1, 1993
PubMed
Summary

Concomitant thoracolumbar and sacral fractures are common in pelvic trauma. Aggressive CT imaging is recommended for sacral fractures, especially with neurological deficits, to guide treatment.

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Area of Science:

  • Orthopedic Surgery
  • Trauma Surgery
  • Radiology

Background:

  • Concomitant thoracolumbar and sacral fractures are a significant subset of pelvic and sacral injuries.
  • Understanding the incidence and characteristics of these combined injuries is crucial for effective management.

Observation:

  • Seventeen patients with concomitant thoracolumbar and sacral fractures were identified, comprising 26% of sacral and 7.7% of pelvic fractures.
  • The cohort presented a bimodal age distribution, with thirteen men and four women.
  • Common thoracolumbar injuries included vertical compression fractures, while sacral fractures varied across Denis zones, with 5/17 missed initially.

Findings:

  • Four patients experienced neurogenic bowel or bladder symptoms.
  • Operative treatment was performed on seven thoracolumbar and three sacral fractures.

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  • Outcomes were generally good to excellent, contingent on the absence of significant initial neurologic injury.
  • Implications:

    • Recommend aggressive computed tomographic (CT) evaluation of the sacrum in cases of suspicious pelvic trauma or discordant neurological findings.
    • Consider surgical decompression for both sacral and thoracolumbar lesions if either could cause neurogenic bowel/bladder dysfunction.