A Novel Technique for Reduction of Unreducible Thoracolumbar and Lumbar Shear fracture in Ankylosing Spondylitis
|IJOCP | April 2014 | Volume 1 | Issue 1 | Page 9
Conference: North Zone Indian Orthopaedic Association Conference, 2014 – Amritsar, India [Click for Full details]
Authors: Rajat Mahajan , Harvinder Singh Chhabra 
Authors Affiliations: Indian Spinal Injuries Centre
Address of Correspondence:
Dr Rajat Mahajan
B22, Brahma Aptt, Sector 7, plot 7, dwarka, delhi- 110075
Introduction– ! Retrospective case series study ! Objective ! Describe a new technique for reduction of thoracolumbar and lumbar shear fracture not reducing through conventional technique in ankylosing Spondylitis. Ankylosing spondylitis (AS) is a seronegative inflammatory arthropathy affecting axial joints of the body which results in bamboo spine and disabling kyphotic deformity. Shear fractures in ankylosed spine are difficult to reduce and is like attempting to reduce ends of a long bone fracture of an extremity. Simple compression from the posterior results in anterior column opening at thoracolumbar and lumbar levels because of the inherent lordosis present there, which usually requires combined approach if gap is extensive. Anterior surgery in AS patients requires lengthy surgery, blood loss and also compromises pulmonary function which is already compromised in these patients. There are no techniques described for reduction of these complex fractures in literature to the best of our knowledge.
Material & Methods: Four patients were operated by a new modified staged posterior approach. Two patients had AIS D neurology ,one patient had AIS A neurology and one patient had normal neurology (AIS E). Patients were operated in a staged procedure in a single sitting as single posterior procedure did not allow for complete reduction of shear fracture. The patients were first positioned prone and instrumentation was done. To close the anterior gap patients were then positioned lateral and reduction and stabilization of fracture was done.
Results: Mean age of the patients was 53 years. Average time of surgery was 3 hours 40 minutes. All four patients operated with this modified posterior approach had fusion six months after surgery. There were no significant complications.
Conclusion: We recommend this technique to be used in fractures at thoracolumbar and lumbar fractures in ankylosed spine as they have tendency to open anteriorly after trauma. It helps in closure of anterior column in a single surgery and obviates the need for anterior surgery in these patients.
|How to Cite this Abstract|
|Mahajan Rajat, Chhabra S Harvinder. A Novel Technique for Reduction of Unreducible Thoracolumbar and Lumbar Shear fracture in Ankylosing Spondylitis. I J Orthopaedic Conference Proceedings. April 2014;1(1):9.|