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Vol. 29. Issue 6.
Pages 304-308 (November - December 2018)
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Vol. 29. Issue 6.
Pages 304-308 (November - December 2018)
Caso clínico
Vertebrectomía total y acortamiento vertebral en el manejo de luxación vertebral T12-L1: manejo con medios subóptimos
Total vertebrectomy and spine shortening for the treatment of T12-L1 spine dislocation: Management with suboptimal resources
Alejandro Lorentea,
Corresponding author
alejandro.lorentegomez@gmail.com

Autor para correspondencia.
, Pablo Palaciosb, Jesús Burgosa, Carlos Barriosc, Rafael Lorented
a Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Ramón y Cajal, Madrid, España
b Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Madrid Norte Sanchinarro, Madrid, España
c Instituto Universitario de Investigación en Enfermedades Músculo-Esqueléticas, Valencia, España
d Servicio de Traumatología y Cirugía Ortopédica, Hospital Universitario Infanta Cristina, Badajoz, España
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Resumen

La vertebrectomía total y el acortamiento vertebral se ha descrito como el tratamiento en el manejo de luxaciones traumáticas vertebrales, tanto en fase aguda como crónica. Presentamos un caso excepcional de una fractura luxación vertebral T12-L1 de 5 semanas de evolución en una mujer de 25 años con paraplejía completa a raíz del traumatismo en Ciudad de León, Nicaragua. Debido al tiempo de evolución de la luxación, realizamos una vertebrectomía completa de L1 para poder reducir la charnela dorsolumbar. Como único material de osteosíntesis disponíamos de 8 tornillos y 2 placas de Steffee, por lo que se implantaron tornillos pediculares en T11, T12, L2 y L3 en el lado derecho y T11, T12, L3 y L4 en el lado izquierdo, y se realizó la reducción de la columna de modo manual. Se colocaron las placas de Steffee y añadimos alambres sublaminares en un intento de reforzar la osteosíntesis. Quince meses después de la cirugía, no ha existido mejoría neurológica.

Palabras clave:
Luxación vertebral
Acortamiento vertebral
Traumatismo
Vertebrectomía
Abstract

Total vertebrectomy with spine shortening has been reported for the treatment of difficult cases of traumatic spine dislocation, both in acute and chronic phase. We report an exceptional case of a five-week-old T12-L1 spine dislocation in a 25-year-old female with complete paraplegia as a result of trauma in Ciudad de León (Nicaragua). In view of the time since the dislocation, we performed a complete L1 vertebrectomy in order to reduce the dorsolumbar hinge. For osteosynthesis material we had only eight screws and two Steffee plates. We therefore introduced pedicle screws at levels T11, T12, L2 and L3 on the right side and T11, T12, L3 and L4 on the left, and performed manual reduction of the spine. Steffee plates were placed and we added sublaminar wires to reinforce the osteosynthesis. Fifteen months after surgery, there has been no neurological improvement.

Keywords:
Vertebral dislocation
Spine shortening
Trauma
Vertebrectomy

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