Dorso-Lumbar Burst Fractures Secondary to a Peculiar Tipper Truck Injury: A Report on Two Cases

Abstract

Spinal injury is a disabling event. Disability primarily depends on the degree of cord injury. Vertebral bone injuries are a frequent accompaniment. Burst fracture of the vertebral body indicates a high-impact nature of injury. Among the various causes of burst fractures with cord injury, road traffic accidents are the most common mode of injury. We report two cases of fractures of dorsolumbar junction in a peculiar truck accident. Both the patients had burst fractures, and presented and continued to have paraplegia despite surgery. The authors want to highlight this peculiar spinal injury and at the same time want to educate the neurosurgeons about this mode of injury. This type of injury has not been reported earlier.

Keywords

spinal fractures - burst fracture - dorsolumbar fracture - tipper truck injury

• References

• 1 Kawu AA. Pattern and presentation of spine trauma in Gwagwalada-Abuja, Nigeria. Niger J Clin Pract 2012; 15 (1) 38-41
• 2 Marré B, Ballesteros V, Martínez C , et al. Thoracic spine fractures: injury profile and outcomes of a surgically treated cohort. Eur Spine J 2011; 20 (9) 1427-1433
• 3 Chiu WT, Lin HC, Lam C, Chu SF, Chiang YH, Tsai SH. Review paper: epidemiology of traumatic spinal cord injury: comparisons between developed and developing countries. Asia Pac J Public Health 2010; 22 (1) 9-18
• 4 Cripps RA, Lee BB, Wing P, Weerts E, Mackay J, Brown D. A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention. Spinal Cord 2011; 49 (4) 493-501
• 5 van den Berg ME, Castellote JM, Mahillo-Fernandez I, de Pedro-Cuesta J. Incidence of spinal cord injury worldwide: a systematic review. Neuroepidemiology 2010; 34 (3) 184-192 , discussion 192
• 6 Wyndaele M, Wyndaele JJ. Incidence, prevalence and epidemiology of spinal cord injury: what learns a worldwide literature survey?. Spinal Cord 2006; 44 (9) 523-529
• 7 Mukherjee AK. Spine Injury and Disability Care. New Delhi, India: Vikas Publishing House; 1999
• 8 Andriacchi T, Schultz A, Belytschko T, Galante J. A model for studies of mechanical interactions between the human spine and rib cage. J Biomech 1974; 7 (6) 497-507
• 9 Bohlman HH, Freehafer A, Dejak J. The results of treatment of acute injuries of the upper thoracic spine with paralysis. J Bone Joint Surg Am 1985; 67 (3) 360-369
• 10 el-Khoury GY, Whitten CG. Trauma to the upper thoracic spine: anatomy, biomechanics, and unique imaging features. AJR Am J Roentgenol 1993; 160 (1) 95-102
• 11 Schweighofer F, Hofer HP, Wildburger R, Stockenhuber N, Bratschitsch G. Unstable fractures of the upper thoracic spine. Langenbecks Arch Chir 1997; 382 (1) 25-28
• 12 Holdsworth FW, Hardy A. Early treatment of paraplegia from fractures of the thoraco-lumbar spine. J Bone Joint Surg Br 1953; 35-B (4) 540-550
• 13 Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 1983; 8 (8) 817-831
• 14 McAfee PC, Yuan HA, Fredrickson BE, Lubicky JP. The value of computed tomography in thoracolumbar fractures. An analysis of one hundred consecutive cases and a new classification. J Bone Joint Surg Am 1983; 65 (4) 461-473
• 15 Zeng ZL, Zhu R, Li SZ , et al. Formative mechanism of intracanal fracture fragments in thoracolumbar burst fractures: a finite element study. Chin Med J (Engl) 2013; 126 (15) 2852-2858
• 16 Holdsworth FW. Fractures, dislocations, and fracture dislocations of the spine. J Bone Joint Surg Br 1963; 45: 6-20
• 17 Heary RF, Kumar S. Decision-making in burst fractures of the thoracolumbar and lumbar spine. Indian J Orthop 2007; 41 (4) 268-276