Document Detail

Shear fracture-dislocations of the thoracic and lumbar spine associated with forceful hyperextension (lumberjack paraplegia).
MedLine Citation:
PMID:  1553586     Owner:  NLM     Status:  MEDLINE    
Twelve patients sustained a shear fracture-dislocation of their thoracic or lumbar spines by a hyperextension mechanism of injury. Ten male and two female patients were injured; their average age was 29 years (range, 22 months to 56 years). Ten fracture-dislocations occurred in the thoracic spine, one at the thoracolumbar junction, and one in the lumbar spine. Eleven patients had complete paraplegia, and one had incomplete paraplegia at the time of injury. Dural tears were found in six of the patients. Eleven patients were treated by posterior spinal fusion with instrumentation, and one was treated with a brace. Three patients were treated with Harrington distraction rods alone, six had Harrington distraction rods supplemented with a midline Harrington compression rod or interspinous wiring, and two were treated with Cotrel-Dubousset instrumentation. No patient was lost to follow-up. The average length of follow-up was 3.5 years (range, 1-9 years). Six of the patients treated with Cotrel-Dubousset instrumentation or Harrington distraction rods supplemented with either a midline compression rod or interspinous wiring healed anatomically; two patients developed pseudarthroses. None of the patients treated with Harrington distraction rods alone healed in an anatomic position. The use of Harrington distraction rods alone was associated with overdistraction and nonanatomic alignment of the spine. The disruption of the anterior stabilizing structures of the spine associated with hyperextension injuries necessitates the use of instrumentation that can stabilize the spine and prevent overdistraction. This injury can be successfully treated with Cotrel-Dubousset or Harrington distraction rods supplemented with either a midline compression rod or interspinous wiring.
F Denis; J K Burkus
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Spine     Volume:  17     ISSN:  0362-2436     ISO Abbreviation:  Spine     Publication Date:  1992 Feb 
Date Detail:
Created Date:  1992-04-30     Completed Date:  1992-04-30     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  156-61     Citation Subset:  IM    
Minnesota Spine Center, Fairview-Riverside Hospital, Minneapolis.
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MeSH Terms
Dislocations / complications*,  epidemiology,  surgery
Follow-Up Studies
Internal Fixators
Lumbar Vertebrae / injuries*
Paraplegia / etiology*
Retrospective Studies
Spinal Fractures / complications*,  epidemiology,  surgery
Spinal Fusion
Thoracic Vertebrae / injuries*
Time Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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