Abstract

BRITO, Joaquim Soares do; FERNANDES, Pedro  and  TIRADO, António. Lesão dural no contexto de fraturas toraco-lombares tipo 'burst' associadas a fraturas em ramo verde das lâminas. Rev. Port. Ortop. Traum. [online]. 2015, vol.23, n.1, pp.77-84. ISSN 1646-2122.

The thoracolumbar burst fracture can be associated with greenstick lamina fractures. This lamina fracture pattern has been recognized as predictor for the presence of dural tears with nerve root entrapment. In this work we review the clinical cases of two patients with high-energy thoracolumbar fractures and imaging evidence of greenstick lamina fracture with incomplete neurological injury. Intraoperatively we observed extensive dural laceration with nerve root entrapment within laminar fracture. A combined surgical approach (posterior-anterior) allowed root liberation prior to any reduction manoeuvre, with a significant neurological recovery in both cases. Recognition of this type of fracture, especially in presence of neurological compromise should recommend a posterior approach first, to allow nerve root liberation and rule out neurological complications.

Keywords : Burst fracture; greenstick lamina fracture; dural tears.

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