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  4. A multilevel noncontiguous spinal fracture with cervical and thoracic spinal cord injury

A multilevel noncontiguous spinal fracture with cervical and thoracic spinal cord injury

International Journal of Surgery Case Reports, 2021 · DOI: https://doi.org/10.1016/j.ijscr.2021.106529 · Published: October 19, 2021

Spinal Cord InjuryResearch Methodology & DesignMusculoskeletal Medicine

Simple Explanation

Multilevel noncontiguous spinal fractures (MNSF) are complex injuries often missed initially, leading to delayed diagnosis and potential spinal deformity and neurological issues. This case report details the surgical management of a patient with MNSF and spinal cord injury affecting both the cervical and thoracic vertebrae. The patient was treated with a cervical orthosis and posterior thoracic decompression and fusion. After treatment and rehabilitation, the patient's sitting and balance improved, although lower extremity function did not due to the severity of the spinal cord injury.

Study Duration
6 months follow-up
Participants
1 male patient
Evidence Level
Level 4, Case Report

Key Findings

  • 1
    MNSF with spinal cord injury following high-velocity accidents are unstable and complex injuries.
  • 2
    Clinical assessment is crucial, as treatment varies according to the specific injuries.
  • 3
    Cervical orthosis and posterior thoracic decompression with fixation is an effective option for patients with MNSF and spinal cord injury.

Research Summary

This case report describes the operative management of an 18-year-old male with a multilevel noncontiguous spinal fracture (MNSF) and spinal cord injury involving the cervical and thoracic vertebrae. The patient underwent posterior thoracic decompression and fusion, along with cervical orthosis treatment. Post-operatively, the patient showed significant improvement in sitting and balance. The authors conclude that posterior thoracic decompression and fusion combined with cervical orthosis is an effective treatment option for MNSF cases involving multilevel spinal cord injury.

Practical Implications

Early Detection of MNFS

Early detection of secondary lesions in MNSF is crucial for preventing complications and achieving optimal clinical outcomes.

Surgical Treatment

Surgical intervention, such as posterior thoracic decompression and fusion, can be an effective treatment for MNSF with spinal cord injury.

Rehabilitation Training

Suitable rehabilitation training, including wheelchair transfer and sitting balance exercises, is essential for improving patient outcomes post-surgery.

Study Limitations

  • 1
    Single case report limits generalizability.
  • 2
    Limited follow-up period of only 6 months.
  • 3
    Focus on surgical management, neglecting other potential interventions.

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