Intraoperative ﬁnding and management of complete spinal cord transection after thoracolumbar traumatic fracture-dislocation: A case report

Medicine, 2021 · DOI: http://dx.doi.org/10.1097/MD.0000000000024096 · Published: January 1, 2021

Simple Explanation

This case report describes the surgical management of a patient who suffered a complete spinal cord transection due to a traumatic fracture-dislocation in the thoracolumbar region of the spine. The patient experienced complete loss of motor and sensory function below the T10 dermatome level. The surgery involved spinal fusion, decompression, and dural sac repair to prevent CSF leakage. Despite the surgical intervention, there was no neurological recovery observed during a 4-year follow-up period. The goal of the surgery was to provide stability and prevent complications like CSF leakage and pain.

Study Duration

4 years

Participants

A 53-year-old man

Evidence Level

Level 4, Case Report

Key Findings

1
The study reports the intraoperative finding and management of complete spinal cord transection in thoracolumbar spine injury, which is rare in reported cases.
2
Perfect spinal fusion is crucial for rehabilitation, daily living, and to prevent complications such as phantom pain in cases of complete spinal cord transection.
3
MRI is indispensable for accurate identification of spinal cord injury before surgical treatment, aiding in decision-making and surgical planning.

Research Summary

This case report details the surgical management of a 53-year-old male with complete spinal cord transection at the T11-T12 level due to a traumatic fracture-dislocation. The surgical intervention included spinal fusion with pedicle screw instrumentation, autobone graft, decompression, and dural sac repair to prevent cerebrospinal fluid leakage. Despite the surgery, no neurological recovery was observed over a 4-year follow-up, highlighting the challenges in treating complete spinal cord transections. Perfect fusion is emphasized to facilitate rehabilitation and prevent complications.

Practical Implications

Surgical Stabilization

Perfect fusion is required to facilitate rehabilitation and daily living, prevent neurogenesis, and prevent unnecessary pain such as phantom pain.

Prevention of Complications

Surgical treatment is performed to avoid pseudomeningocele, CSF leakage, and infection.

Diagnostic Importance of MRI

MRI is indispensable for accurate identification of the spinal cord injury before surgical treatment.

Study Limitations

1
Single case report limits generalizability.
2
Lack of neurological recovery despite intervention.
3
Limited ability of the central nervous system to repair itself following injury

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