Skip to main content
SpringerLink
Log in

Problems in Spinal Fractures

  • Chapter
Current Practice of Fracture Treatment

  • 208 Accesses

Abstract

Several major goals should be attained in the ideal treatment of any spinal injury. Spinal alignment must be restored by appropriate means of reduction to retain normal spinal biomechanics. This allows early painless mobility, prevents or minimizes neurological deficits, provides stability at the injured site, and prevents progressive late-occurring spinal deformity, pain and possible neural compromise. The treatment should also aim to provide the neural structures with the optimal environment for function, healing and regeneration and minimize non-spinal complications such as deep vein thrombosis, pulmonary embolism, decubitus ulcers, and chest and urinary tract infections.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Whitesides TE (1977) Traumatic kyphosis of the thoracolumbar spine. Clin Orthop 128:78–92

    PubMed  Google Scholar 

  2. White AA, Panjabi MM (1978) Clinical biomechanics of the spine. Lippincott, Philadelphia

    Google Scholar 

  3. Denis F (1983) The three column spine and its significance in the classification of acute thoraco-lumbar spinal injuries. Spine 8:817–831

    Article  PubMed  CAS  Google Scholar 

  4. Denis F (1984) Spinal instability as defined by the three-column spine concept in acute spinal trauma. Clin Orthop 189:65–76

    PubMed  Google Scholar 

  5. Holdsworth F (1970) Fractures, dislocations and fracture-dislocations of the spine. J Bone Joint Surg [Am] 52:1534–1551

    CAS  Google Scholar 

  6. Kobrine AI, Bernstein JJ (1985) Experimental spinal cord injury. In: Wilkins RH, Rengachary SS (eds) Neurosurgery, vol 2. McGraw-Hill, New York, pp 1694–1700

    Google Scholar 

  7. Bricolo A, Dalle Ore G et al. (1976) Local cooling in spinal cord injury. Surg Neurol 6:101–106

    PubMed  CAS  Google Scholar 

  8. Abraham J, Paterson A et al. (1987) Omento-myelo-synangiosis in the management of chronic traumatic parapledia. Paraplegia 25:44–49

    Article  PubMed  CAS  Google Scholar 

  9. Yashon D (1988) Surgical management of trauma to the spine. In: Schmidek HH, Sweet WH (eds) Operative neurosurgical techniques, 2nd edn. Grune and Stratton, New York, pp 1449–1469

    Google Scholar 

  10. Sherrington CS (1947) The integrative action of the nervous system, 2nd edn. Yale University Press, New Haven

    Google Scholar 

  11. Schneider RC (1955) Syndrome of acute anterior spinal cord injury. J Neurosurg 12:95–122

    Article  PubMed  CAS  Google Scholar 

  12. Pang D, Wilberger JE Jr (1982) Spinal cord injury without radiographic abnormalities in children. J Neurosurg 57:114–119

    Article  PubMed  CAS  Google Scholar 

  13. Pollack IF, Pang D et al. (1988) Recurrent spinal cord injury without radiographic abnormalities in children. J Neurosurg 69:177–182

    Article  PubMed  CAS  Google Scholar 

  14. Hadley MN, Zabramski JM et al. (1988) Paediatric spinal trauma: review of 122 cases of spinal cord and vertebral column injuries. J Neurosurg 68:18–24

    Article  PubMed  CAS  Google Scholar 

  15. Foo D, Rossier AB (1982) Post-traumatic spinal epidural hematoma. Neurosurgery 11:25–32

    Article  PubMed  CAS  Google Scholar 

  16. Berquist TH (1986) Imaging of orthopaedic trauma and surgery. Saunders, Philadelphia

    Google Scholar 

  17. Bools JC, Rose BS (1986) Traumatic atlanto-occipital dislocation: two cases with survival. AJNR 7:901–904

    PubMed  CAS  Google Scholar 

  18. Bohlman H, Ducker T, Lucas J (1982) Spine and spinal cord injuries. In: Rothman R, Simeone F (eds) The spine, 2nd edn. Saunders, Philadelphia, pp 661–756

    Google Scholar 

  19. Powers B, Miller MD et al. (1979) Traumatic anterior atlanto-occipital dislocation. Neurosurgery 4:12–17

    Article  PubMed  CAS  Google Scholar 

  20. Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg [Am] 56:1663–1674

    CAS  Google Scholar 

  21. Clark C, White A (1985) Fractures of the dens. J Bone Joint Surg [Am] 67:1340–1348

    CAS  Google Scholar 

  22. Southwick W (1980) Management of fractures of the dens. J Bone Joint Surg [Am] 62:482–486

    CAS  Google Scholar 

  23. Daffner RH (1977) Pseudo fracture of the dens: Mach bands. Am J Radiol 128:607–612

    CAS  Google Scholar 

  24. Cancelmo JJ (1972) Clay shoveler’s fracture: a helpful diagnostic sign. Am J Radiol 115:540–543

    Google Scholar 

  25. Kim KS, Chen HH et al. (1989) Flexion teardrop fracture of the cervical spine: radiographic characteristics. Am J Radiol 152:319–326

    CAS  Google Scholar 

  26. Harris JH (1978) Acute injuries of the spine. Semin Roentgenol 13:53–68

    Article  PubMed  Google Scholar 

  27. Lee C, Kim KS, Rogers LF (1982) Triangular cervical vertebral body fractures: diagnostic significance. Am J Radiol 138:1123–1132

    CAS  Google Scholar 

  28. Martinez S, Morgan CL et al. (1979) Unusual fractures and dislocations of the axis vertebra. Skeletal Radiol 3:206–212

    Article  Google Scholar 

  29. Lee C, Rogers LF et al. (1984) Fractures of the cranio-vertebral junction associated with other fractures of the spine: overlooked entity? AJNR 5:775–781

    PubMed  CAS  Google Scholar 

  30. Mirvis S, Young J et al. (1987) Hangman’s fracture: radiologic assessment in 27 cases. Radiology 163:713–717

    PubMed  CAS  Google Scholar 

  31. Peppin J, Hawkins R (1981) Traumatic spondylolisthesis of the axis: hangman’s fracture. Clin Orthop 157:133–138

    Google Scholar 

  32. Effendi B, Roy D et al. (1981) Fractures of the ring of the axis: a classification based on the analysis of 131 cases. J Bone Joint Surg [Br] 63:319–327

    Google Scholar 

  33. Elliott JM, Rogers LF et al. (1972) The hangman’s fracture: fractures of the neural arch of the axis. Radiology 104:303–307

    PubMed  Google Scholar 

  34. Seljeskog EL, Chou SH (1976) Spectrum of the hangman’s fracture. J Neurosurg 45:3–8

    Article  PubMed  CAS  Google Scholar 

  35. Miller MD, Gehweiler JA et al. (1978) Significant new observations on cervical spine traumas. Am J Radiol 130:659–663

    CAS  Google Scholar 

  36. Ballinger PW (ed) (1986) Merrill’s atlas of radiographic positions and radiographic procedures, vol 1, 6th edn. Mosby, St Lauis

    Google Scholar 

  37. Koch RA, Nickel VL (1978) The halo-vest: an evaluation of motion and forces across the neck. Spine 3:103–107

    Article  PubMed  CAS  Google Scholar 

  38. Han SY, Witten DM, Mussleman JP (1976) Jefferson fracture of the atlas. J Neurosurg 44:368–371

    Article  PubMed  CAS  Google Scholar 

  39. Sherk HH, Nicholson JT (1970) Fractures of the atlas. J Bone Joint Surg [Am] 52:1017–1024

    CAS  Google Scholar 

  40. Spence K, Decker S, Sell K (1970) Bursting atlantal fracture associated with rupture of the transverse ligament. J Bone Joint Surg [Am] 52:543–546

    Google Scholar 

  41. Zielinski C, Gunther S, Deeb Z (1982) Cranial nerve palsies complicating Jefferson fractures. J Bone Joint Surg [Am] 64:1382–1384

    CAS  Google Scholar 

  42. Segal LS, Grimm JO, Stauffer ES (1987) Non-union of fractures of the atlas. J Bone Joint Surg [Am] 69:1423–1434

    CAS  Google Scholar 

  43. Perry J, Nickel VL (1959) Total cervical spine fusion for neck paralysis. J Bone Joint Surg [Am] 41:37–59

    Google Scholar 

  44. Anderson LD, D’Alonzo RT (1974) Fractures of the odontoid process of the axis. J Bone Joint Surg [Am] 56:1663–1674

    CAS  Google Scholar 

  45. Chan RC, Schweigel JF, Thompson GB (1983) Halo-thoracic brace immobilization in 188 patients with acute cervical spine injuries. J Neurosurg 58:508–515

    Article  PubMed  CAS  Google Scholar 

  46. Cooper PR, Maravilla KR et al. (1979) Halo immobilization of cervical spine fractures. Indications and results. J Neurosurg 50:603–610

    Article  PubMed  CAS  Google Scholar 

  47. Koch RA, Nickel VL (1978) The halo vest. Spine 3:103–107

    Article  CAS  Google Scholar 

  48. Kostuik JP (1981) Indications for the use of halo immobilization. Clin Orthop 154:46–50

    PubMed  Google Scholar 

  49. Schweigel JF (1979) Halo-thoracic brace management of odontoid fractures. Spine 4:192–194

    Article  PubMed  CAS  Google Scholar 

  50. Seljeskig EL (1978) Non-operative management of acute upper cervical injuries. Acta Neurochir (Wien) 41:87–100

    Article  Google Scholar 

  51. Zwerling MT, Riggins RS (1974) Use of the halo apparatus in acute injuries of the cervical spine. Surg Gynecol Obstet 138:189–193

    PubMed  CAS  Google Scholar 

  52. Zimmerman E, Grant J et al. (1976) Treatment of Jefferson fracture with a halo apparatus. Report of two cases. J Neurosurg 44:372–375

    Article  PubMed  CAS  Google Scholar 

  53. Garfin SR, Botte MJ et al. (1986) Complications in the use of the halo fixation device. J Bone Joint Surg [Am] 68:320–325

    CAS  Google Scholar 

  54. Goodman ML, Nelson PB (1987) Brain abscess complicating the use of a halo orthosis. Neurosurgery 20(1):27–30

    Article  PubMed  CAS  Google Scholar 

  55. Humbyrd DE, Latimer FR et al. (1981) Brain abscess as a complication of halo traction. Spine 6:365–368

    Article  PubMed  CAS  Google Scholar 

  56. Victor DI, Bresnan MJ, Kellar RB (1973) Brain abscess complicating the use of halo traction. J Bone Joint Surg [Am] 55:635–639

    CAS  Google Scholar 

  57. Botte MJ, Byrne T, Garfin SR (1987) Application of the halo cervical immobilizer utilizing an increased torque pressure. J Bone Joint Surg [Am] 69:750–753

    CAS  Google Scholar 

  58. Andriacchi TP, Schultz AB et al. (1974) A model for studies of mechanical interactions between the human spine and rib cage. J Biomech 7:497

    Article  PubMed  CAS  Google Scholar 

  59. Markolf KL (1972) Deformation of the thoraco-lumbar intervertebral joints in response to external loads: a biomechanical study using autopsy material. J Bone Joint Surg [Am] 54:511–533

    CAS  Google Scholar 

  60. White AA, Hirsch C (1971) The significance of the vertebral posterior elements in the mechanics of the thoracic spine. Clin Orthop 81:2–14

    Article  PubMed  Google Scholar 

  61. Dommisse GF (1974) The blood supply of the spinal cord. A critical vascular zone in spinal surgery. J Bone Joint Surg [Br] 56:225–235

    CAS  Google Scholar 

  62. Ferguson RL, Allen BL (1984) A mechanistic classification of thoraco-lumbar spine fractures. Clin Orthop 189:77–88

    PubMed  Google Scholar 

  63. McAfee PC, Yuan HA et al. (1983) The value of computed tomography in thoraco-lumbar fractures: an analysis of 100 consecutive cases and a new classification. J Bone Joint Surg [Am] 65:461–473

    CAS  Google Scholar 

  64. Bohlman HH (1985) Current concepts review: treatment of fractures and dislocations of the thoracic and lumbar spine. J Bone Joint Surg [Am] 67:165–169

    CAS  Google Scholar 

  65. McAfee PC, Yuan HA, Lasda NA (1982) The unstable burst fracture. Spine 7:365–373

    Article  PubMed  CAS  Google Scholar 

  66. McAfee PC, Bohlman HH, Yuan HA (1985) Anterior decompression of traumatic thoraco-lumbar fractures with incomplete neurological deficit using a retroperitoneal approach. J Bone Joint Surg [Am] 67:89–104

    CAS  Google Scholar 

  67. Kaneda K, Abumi K, Fujiya M (1984) Burst fractures with neurologic deficits of the thoracolumbar spine. Results of anterior decompression and stabilization with anterior instrumentation. Spine 9:788–795

    Article  PubMed  CAS  Google Scholar 

  68. Kostuik JP (1984) Anterior fixation for fractures of the thoracic and lumbar spine with or without neurologic involvement. Clin Orthop 189:103

    PubMed  Google Scholar 

  69. Edwards CC, Levine AM (1986) Early rod sleeve stabilization of the injured thoracic and lumbar spine. Orthop Clin North Am 17:122–145

    Google Scholar 

  70. Chance GQ (1948) Note on a type of flexion fracture of the spine. Br J Radiol 21:452–453

    Article  PubMed  CAS  Google Scholar 

  71. Kaufer H, Hayes JT (1966) Lumbar fracture-dislocation - a study of twenty-one cases. J Bone Joint Surg [Am] 48:712–730

    CAS  Google Scholar 

  72. Morgan TH, Wharton GW, Austin GN (1970) The results of laminectomy in patients with incomplete spinal cord injuries. J Bone Joint Surg [Am] 52:822

    Google Scholar 

Download references

Authors
  1. S. Y. Lee
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Orthopaedics & Traumatology, Faculty of Medicine, The Chinese University of Hong Kong Prince of Wales Hospital, Shatin, N.T., Hong Kong

    P. C. Leung

Rights and permissions

Reprints and permissions

Copyright information

© 1994 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Lee, S.Y. (1994). Problems in Spinal Fractures. In: Leung, P.C. (eds) Current Practice of Fracture Treatment. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-78603-7_15

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-78603-7_15

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-78605-1

  • Online ISBN: 978-3-642-78603-7

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation