Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
neurosurgery.fr
06-SPTEMBER-2009 DIYAA AHMAD AREF 22 YEARS
BURST FRACTURE OF D9 AND WEDGING OF D10.
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Anamnesis:
The patient after suffering
RTA 4 days ago got back pain without loss of
consciousness and was admitted elsewhere.
MRI dorsal spine performed
showing burst fracture D9 and wedging of D10.
CT-scan also confirmed the diagnosis. The
patient was transferred to Shmaisani hospital 2
days ago.
On examination: the patient
is in complete bed rest and he was
neurologically free.
Skeletonization of D8 down to
D11 was performed. The lamina of D9 was shifted
posteriorly and deformed and the compressing
elements from behind were removed trying the
keep the acceptable anatomical structures. Using
transpedicualr screws 2 at D8 and 2 at D11 and
one at the right side of D10, which seems to be
intact, distraction reduction was performed
trying to gain reduction due to minimal traction
and mild angulations of the rods. All the time
the procedure was performed using
image-intensifier. The body of D9 got acceptable
alignment due to liagamentotaxis. A 23 mm bridge
was aided to the construct and bicalphos
granules 20 cc seeded around the construct and
at the fractures sites.
Routine closure of the
wound and smooth
postoperative recovery
and the patient sent to
the ward.
Comments
The fracture of D9 was
unstable one, which could lead to catastrophic
residual if neglected.
The body of D10 was partially
acceptable and it was used in the fusion process
at the healthy pedicle to have more stable
construct.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
