Cirugía de columna. Ortopedia y Traumatología: Discusión entre pares / 25yrs old female,with l1 f,how many level must be fixed? Without neurological defection

martes, 22 de abril de 2014

25yrs old female,with l1 f,how many level must be fixed? Without neurological defection

Saankritya Ayan I wud do 2 up yo down . Junctional area , calls for meticulous contouring.

20 de abril a la(s) 22:26 · Me gusta
Swetabh Verma Lucky pt to have escaped neurodeficits..this is an unstable fracture for sure and a ct would reveal retropulsion to cAnal..although even 70% canal compromise is ok sometimes, yet fixing the fracture atleast 2 level up and down would provide the much needed stability..not much role of any anterior column support by bone graft/ cage..posterior ligament repair would ensure a healthy tension band and much needed stability for early ambulation of pt..plz do get a CT also before proceeding

Ayer a las 8:52 · Me gusta
Kedar Phadke So we get a CT, plan 2 up 2 down. No cage/bg?

Ayer a las 22:34 · Me gusta
Swetabh Verma Planning for a facetal fusion, pushing some bone graft anteriorly would b more wise than doing a challenging surgery like expandable/ mesh cage..moreover the pt is neurologically intact..

Ayer a las 22:41 · Me gusta
Swetabh Verma Even to plan any anterior column support we need a ct for applying mc cormack and gaines classfn..still i feel this pt would do equally good if only posterior fixation and fusion is attempted

Ayer a las 22:44 · Me gusta
Kedar Phadke Yup I agree. CT is a must. And only posterior

Ayer a las 22:53 · Me gusta
Vedant Vaksha If no neuro deficit, only post fusion is ok. If u get a good purchase in L1 b/l pedicles, stopping at L2 may be sufficient. Going to L3 will also not be very detrimental!!