|
KMID : 0388720190260040166
|
|
Journal of Korean Society of Spine Surgery
2019 Volume.26 No. 4 p.166 ~ p.171
|
|
|
Three-Column Fracture in the Thoracolumbar Junction Caused by Low-Energy Trauma in a Patient with Baastrup Disease - A Case Report -
|
|
Park In-Keun
Lee Jun-Ku
Seo Jung-Gook
|
|
|
Abstract
|
|
|
Study Design: Case report.
Objectives: We report a case of 3-column fracture caused by low-energy trauma in a patient with Baastrup disease who complained of acute radiating pain and motor weakness in the lower limbs after 3 weeks of conservative treatment. Subsequently, posterior fusion surgery was performed.
Summary of Literature Review: Baastrup disease is characterized by enlargement and close approximation of adjacent spinous processes, and it mostly affects the L4-5 level of the spine. In patients with Baastrup disease affecting multiple levels of the lumbar spine, low-energy trauma can cause an unstable 3-column fracture with neurological compromise. Early recognition and surgical treatment prior to the emergence of a neurological deficit are required.
Materials and Methods: An 84-year-old woman presented with back pain after falling down backward and colliding with the edge of a shelf at ground level. Considering the patient’s general condition and age, she was initially treated with close observation and placement of a spinal brace with serial radiographic follow-up.
Results: Computed tomography found 3-column fracture at the T11 level, which is quite rare in cases of minor trauma. At a 3-week follow-up, she complained of gradual lower extremity weakness, and her general lower extremity motor function decreased to grade 1?2. The patient underwent posterior fusion 2 levels above and below the affected vertebral body (T9-10-12-L1). Surgery was uneventful and the patient’s motor function recovered.
Conclusions: In patients with Baastrup disease affecting multiple levels of the lumbar spine, based on our experience, low-energy trauma can cause an unstable 3-column fracture with neurological compromise. We highly recommend scrutiny of the interspinous space in elderly patients, especially those with a spinal fracture caused by low-energy trauma.
|
|
|
KEYWORD
|
|
|
Baastrup’s disease, Kissing spine, Three-column fracture, Posterior fusion
|
|
|
FullTexts / Linksout information
|
|
 
|
|
|
Listed journal information
|
|
  
|