Most of the site will reflect the ongoing surgical activity of Prof. Munir Elias MD., PhD. with brief slides and weekly activity. For reference to the academic and theoretical part, you are welcome to visit
neurosurgery.tv
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02-MARCH-2011 HASAN AL-SAYYED SALEM 31 YEARS BURST
FRACTURE L2 WITH BONY COMPRESSION.
Anamnesis
The patient
was admitted to Shmaisani hospital
01-March-2011 after falling from the 7th to the
5th floor 10 meters height. There
was loss of consciousness for seconds with
resultant burst fracture of L2 and fracture both
bones midthird left forearm.
CT lumbar spine done
01-March-2011 showing burst fracture of L2
with bony compression of the canal and fracture
of the lamina of L2 with the left pedicle
destroyed.
On
examination: The patient has bruises in
several parts of his body and he was
neurologically free.
Using image-intensifier, skeletonization of
L1-2-3 was performed. There was disruption of
the intraspinous ligament between L2-3 and
fracture of the L2 lamina. Using Expedium (Depuy Spine)
2 polyaxial transpedicular screws 6x40 mm were
inserted to the L1 body. 2 monoaxial 6x40 mm
transpedicular screws were inserted to L3 body
and one screw to the right pedicle of L2 6x35 mm.
Using slightly bended rods 85 mm length were inserted and
reduction with fixation was achieved. The bony
alignments reduced properly. Cross bar was added
for more stability with Vitos bone chips
were used lateral to the rods.
Routine
closure of the wound. Smooth postoperative
recovery.
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Comments
The fracture is unstable one
and compressing the dura more than 35% of
the canal and the posterior elements were also
fractured, for what surgery was needed.
Notice: Not all operative activities
can be recorded due to lack of time.
Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
