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Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing:A report of two cases

Chinese Journal of Traumatology 2021年第6期24卷 397-400页

作者： Paul C.Ivancic North Haven Connecticut06473USA

We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse *** examined the injury mechanism based upon the patients’diagnostic images and video footage of races,in which the accidents *** imaging of patient 1(a 42 years old male)revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/*** existed 22°focal kyphosis at T5/6,anterolisthesis of T5 relative to T6,T5/6 disc herniation,cord edema and epidural hemorrhage from T4 through T6,and cord injury from C3 through *** imaging of patient 2(a 23 years old male)revealed T4/5 fracture/dislocation causing incomplete paralysis below spinal *** existed compression fractures at T5,T6,and T7;4 mm anterior subluxation of T4 on T5;diffuse cord swelling from T3 through T5;comminuted fracture of the C1 right lateral mass;right frontal traumatic subarachnoid hemorrhage;and extensive diffuse axonal *** injuries were caused by high energy flexion-compression of the mid-thoracic spine with a flexed posture upon *** results suggest that substantially greater cord compression occurred transiently during trauma as compared to that documented from admission *** footage of the accidents indicated that the spine buckled and failed due to abrupt pocketing and deceleration of the head,neck and shoulders upon impact with the ground combined with continued forward and downward momentum of the torso and lower *** a similar mechanism is well known to cause fracture/dislocation of the cervical spine,it is less common and less understood for mid-thoracic spine *** study provides insight into the etiology of fracture/dislocation patterns of the mid-thoracic spine due to falls during horse racing.

关键词： Fracture/dislocation thoracic spine Injury mechanism Biomechanics Horse racing

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thoracic giant cell tumor after two total en bloc spondylectomies including one emergency surgery:A case report

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World Journal of Clinical Cases 2024年第16期12卷 2894-2903页

作者： Hai-Feng Liang Hao Xu Meng-Na Zhan Jian Xiao Juan Li Qin-Ming Fei Department of Orthopaedic Surgery Zhongshan HospitalFudan UniversityShanghai 200032China Department of Orthopaedic Surgery Shanghai Geriatric Medical CenterShanghai 201104China Department of Pathology Zhongshan HospitalFudan UniversityShanghai 200032China Department of Orthopaedic Surgery Zhongshan Hospital Wusong BranchFudan UniversityShanghai 200940China

BACKGROUND For patients with acute paraplegia caused by spinal giant cell tumor(GCT)who require emergency decompressive surgery,there is still a lack of relevant reports on surgical *** study is the first to present the case of an acute paraplegic patient with a thoracic spinal GCT who underwent an emergency total en bloc spondylectomy(TES).Despite tumor recurrence,three-level TES was repeated after denosumab *** SUMMARY A 27-year-old female patient who underwent single-level TES in an emergency presented with sudden severe back pain and acute paraplegia due to a thoracic spinal *** emergency TES,the patient's spinal cord function recovered,and permanent paralysis was *** postoperative histopathological examination revealed that the excised neoplasm was a rare ***,the tumor recurred 9 months after the first *** 12 months of denosumab therapy,the tumor size was reduced,and tumor *** prevent recurrent tumor progression and provide a possible cure,a three-level TES was performed *** patient returned to an active lifestyle 1 month after the second surgery,and no recurrence of GCT was found at the last *** This patient with acute paraplegia underwent TES twice,including once in an emergency,and achieved good therapeutic *** in emergency surgery is feasible and safe when conditions permit;however,it may increase the risk of tumor recurrence.

关键词： Giant cell tumor thoracic spine Emergency treatment Total en bloc spondylectomy Denosumab therapy Case report

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Circumspinal decompression through a single posterior incision to treat thoracolumbar disc herniation

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Chinese Medical Journal 2011年第23期124卷 3852-3857页

作者： QI Qiang CHEN Zhong-qiang LIU Ning GUO Zhao-qing SHI Ze-feng LIU Zhong-jun LIU Xiao-guang LI Wei-shi ZENG Yan SUN Chui-guo Department of Orthopaedics Peking University Third Hospital Beijing 100191 China

Various surgical approaches have been successfully used in the treatment of thoracolumbar disc herniation （TLDH）. Although the anterior transthoracic approach has a reputation for better visualization than the posterolateral and lateral approaches, it involves the manipulation of the thoracic and pulmonary structures. Thus, this approach is technically demanding and prone to compromising the respiratory system. An ideal approach would involve adequate visualization and be accomplished through the posterior midline approach that is familiar to spine surgeons. The objective of this retrospective preliminary clinical study was to introduce a new surgical procedure, circumspinal decompression through a single posterior incision, for the treatment of TLDH （T10/11-L1/2） and to evaluate the surgical outcome of this procedure by comparing it to the conventional anterior transthoracic approach. Methods In this study, 15 patients （10 males, 5 females; mean age 51 years） with symptomatic TLDH underwent the circumspinal decompression through a single posterior incision procedure between January 2008 and December 2009. Altogether, 17 herniated discs were excised, with 2 discs at T10/11, 4 discs at Tll/12, 5 discs at T12/L1 and 6 discs at L1/2. Of these patients, 13 were followed up with a mean follow-up period of 23.5 months. Clinical outcomes, including operative time, blood loss, perioperative complications, postoperative time of hospitalization, neurologic status improvement, back pain and correction of local kyphosis, were investigated by comparing these data with the results from patients who underwent the anterior transthoracic approach for TLDH during the same period. The patients＇ neurologic status was evaluated by a modified Japanese Orthopedic Association （JOA） scoring system of 11 points. Neurologic status improvement after the surgery was assessed by calculating the recovery rate, which was equal to the （postoperative JOA score-preoperative JOA score）/（11-preoperativ

关键词： thoracolumbar disc herniation circumspinal decompression thoracic spine

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Recurrent perimedullary arteriovenous fistula at thoracic level

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Chinese Medical Journal 2006年第24期119卷 2138-2140页

作者： HAI Jian CHEN Zuo-quan DENG Dong-feng PAN Qing-gang LING Feng Department of Neurosurgery Tongji Hospital Tongji University Shanghai 200065 China

Perimedullary arteriovenous fistula （PMAVF, type Ⅳ spinal cord arteriovenous malformation,SCAVM） is a direct arteriovenous shunt without abnormal vascular connection between the feeding artery and draining vein. Most patients with PMAVF present with a progressive myelopathy caused by venous hypertension, resulting in disabling deficits and incurable complete transverse myelopathy. The lesion is usually located on the surface of the spinal cord or under the pia mater at the level of the conus medullaris or cauda equina, thoracic PMAVF is rarely encountered. Most PMAVFs are fed by the anterior spinal artery （ASA）, posterior spinal artery （PSA）, or both Multiple arterial feeders from the ASA can make the treatment of the disease difficult From August 2004 to February 2005, we treated a patient with a recurrent PMAVF （type Ⅳb） at the thoracic level with multiple blood supply.

关键词： perimedullary arteriovenous fistula thoracic spine surgery

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Is T1-2 Disc Herniation Rare? A Case Report

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International Journal of Clinical Medicine 2014年第8期5卷 444-446页

作者： Murat Aydin Emrah Akcay Alattin Yurt Department of Neurosurgery Bozyaka Educational and Research HospitalIzmirTurkey

Backround: The English literature contains very few reports on disc herniation at upper thoracic levels. This report presents a patient with T1-2 disc herniation who underwent successful surgery. Case Presentation: A 47-year-old female presented that the right T1 root was compressed by foraminal disc herniation at the T1-2 level. Conclusion: The anterior approach is an easy and appropriate method to treat central and foraminal disc herniation of the thoracic spine.

关键词： Disc Herniation thoracic spine T1-2 Level Surgery

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