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THE RESULTS OF EARLY OPERATIVE TREATMENT OF THE LUMBAR VERTEBRA FRACTURES WITH NEUROLOGIC DEFICIT

  • M. F. Akyıldız

J Turk Spinal Surg 1990;1(3):148-150

Between 1986 and 1990 three patients with neurologic deficit because of lomber vertabrate fracture were operated inOrthophaedics Department of S.B. Ankara Hst. and S.B. Haseki Hst.Istanbul. The cases were prepared to surgical procedure within 6-24-36 hours separetely, and followed -up to one year. The type of the fractures were determined, by x-ray and CAT scans,. The criterium were the degree of the deficit according to the Frankel classification, the response to the Bulbocaverneuse Reflex and the obstruction of the neural canal. The technique applied was neural decomppression combined with classical Dual Harrington Distraction Rods. I observed the recovery of medullar compression, beginning from the post-operative second day and a good recovery with in 6-12 months.

Keywords: In a paraplegic patients inspite the motor and sensorial loose, the return of the reflex in posttraumatic 24-48 hours, show that the prognosis is bad, prooving the lesion is in the cord and irreversible. In two of the patients the reflex did not exist in 36 hours and give us the indication to open reduction and posterior decompression before 48 hours to eliminate the neuralischemia. The third patient with total paraplegia had free bone fragments in the neural canal and the Bulbo-Caverneuse Reflex was negative. He was operated in the sixth hour after the trauma. The prognosis is reported below.