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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01-MARCH-2011 IYAD RAYEQ ALSOOS 31 YEARS
BURST FRACTURE L3 WITH BONY COMPRESSION.
Anamnesis
The patient
was admitted to Shmaisani hospital
28-February-2011 after falling inside the the
falling escalator for 10 meters height. There
was loss of consciousness for seconds with
resultant burst fracture of L3.
CT lumbar spine done
28-February-2011 showing burst fracture of L3
with bony compression of the canal.
On
examination: The patient has bruises in
several parts of his body and he was
neurologically free.
Using image-intensifier, skeletonization of
L2-3-4 was performed. There was no evident
fracture of the posterior elements, nor
disruption of the ligamental structures. There
was only fracture of the tip of the right L4
transverse process. Using Expedium (Depuy Spine)
2 polyaxial transpedicular screws 6x40 mm were
inserted to the L2 body. 2 monoaxial 6x45 mm
transpedicular screws were inserted to L4 body.
Using 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 bone graft
βTCP 40 cc
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 more than 60% of
the canal, 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 .
