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04-JUNE-2009  FARHAN SULAYMAN AWWAD  49 YEARS  BURST FRACTURE D11 WITH MILD COMPRESSION OF THE SPINAL CORD.

Anamnesis:

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The patient suffered RTA 31-May-2009 with trivial head injury and contusion of the kidneys and burst fracture of D11 with minimal compression of the spinal cord and linear fractures of the surrounding ribs. The patient was transferred from another hospital.

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On examination: the patient was neurologically free and he was bedridden with corset at the lumbo-dorsal region.

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MRI lumbar spine, which was done 01-June-2009 which confirmed the diagnosis and CT-scan of the abdomino-pelvic region and the fractured D11 area were performed.

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Using image-intensifier, the D11 was identified. Skeletonization of D9-10 and D12 and L1 was performed with preservation of the interspinous ligament, which proved to be intact. Using sublaminar hooks at the laminae of D9, 10 and D12 and L1 and rods, reduction with distraction and fixation was applied. The rods were modeled and bended to imitate the normal curvature of the area. Serial check X-rays were performed to see to reduction of the deformed vertebral body of D11.

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Smooth postoperative recovery with preservation of the neural functions.

Comments

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The patient was planned in the other hospital to undergo surgery with corporectomy and cage replacement?? The best policy is to achieve the best result with less destructive surgery. In this case the preservation of the interspinous ligament and the anterior and posterior longitudinal ligaments make the extreme plan for corporectomy meaningless. The aim of surgery to reduce to involved vertebra and decrease the degree of the compression and most important the achieve stability for early mobilization of the patient.

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Notice: Not all operative activities can be recorded due to lack of time.
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