Journal of Musculoskeletal Trauma

Original Articles

Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures: Ki Chan An, Dae Hyun Park, Yong Wook Kwon; J Korean Fract Soc 2011;24(3):256-261. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.256

PURPOSE
To investigate the relationship between the greenstick laminar fractures and the dural tear in low lumbar burst fractures and their optimal treatment.
MATERIALS AND METHODS
We enrolled 51 patients (52 cases) who had been diagnosed with low lumbar burst fracture from June 2003 to May 2007. The average age was 39 years (range, 22 to 58), 30 male patients (58.8%), and 21 female patients (41.2%). Average follow-up periods was 19 months (range, 11 to 45). Lumbar CT scan were taken 1 mm slices in precision for all patients. We judged it incomplete fracture if lumbar CT scans show loss of cortical continuity over 3 slices if there is an aggrement of two among one radiologist and two orthopaedic surgeons reached a consensus. Dural tear and entrapment of nerve root were confirmed intraoperatively by the senior surgeon.
RESULTS
In 52 burst fractures, complete lamina fractures occurred in 21 cases and there were green stick laminar fractures in 14 cases. Neurologic defect has been found in 12 cases, 5 (63%) from complete laminar fractures and 3 (37%) from green stick laminar fractures. Dural tears has been detected in 9 cases (26%), 4 (19%) from complete laminar fractures and 5 (36%) from green stick laminar fractures.
CONCLUSION
Dural tear and nerve root entrapment can be accompanied in patients with green stick fracture. There is necessary to consider the possibility of dural tear and nerve root entrapment before operation and to indentify carefully to the presence of nerve root entrapment during operation.

Citations

Citations to this article as recorded by

Risk factors for damage to the dura mater in thoracic and lumbar spine injury
A. G. Martikyan, A. A. Grin, A. E. Talypov, S. L. Arakelyan
Hirurgiâ pozvonočnika (Spine Surgery).2022; 19(1): 31. CrossRef
Clinical Efficacy of Large-Channel Percutaneous Lumbar Endoscopic Decompression in the Treatment of Lumbar Spinal Stenosis Secondary to Old Compression Fractures
Junlin Liu, Qingquan Kong, Walter Munesu Chirume, Pin Feng, Bin Zhang, Junsong Ma, Yuan Hu
World Neurosurgery.2022; 166: e118. CrossRef
Diagnostics, pathogenesis and treatment of damage to the dura mater in spinal injury
A. G. Martikyan, A. A. Grin
Russian journal of neurosurgery.2018; 20(2): 74. CrossRef

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Relevancy of Posterior Column Injury and Dural Tear in Unstable Burst Fracture: Ye Soo Park, Kee Hun Son, Ki Chul Park, Il Hoon Sung, Jae Lim Cho; J Korean Fract Soc 2005;18(1):65-68. Published online January 31, 2005; DOI: https://doi.org/10.12671/jkfs.2005.18.1.65

Abstract PDF

PURPOSE
To analyze the pattern of posterior column injury in unstable burst fractures and to predict the possibility of dural injury.
MATERIALS AND METHODS
Retrospective review was carried out on 22 patients of unstable burst fracture from Nov. 1996 to Sep. 2003. The pattern posterior column injury was analyzed by simple x-ray, CT and MRI findings. In simple x-ray, authors analyzed laminar fracture, posterior facet injury, inter-spinous widening and inter-spinous malalignment, posterior bony injury by CT, posterior inter-spinous ligament injury and dural tear by MRI. The statistical analysis was performed using Mann-Whitney test and Chi-square test.
RESULTS
There were 13 men and 9 women, and mean age was 41 years-old (18~65). The level of injury showed 15 cases in T12-L2, 6 in L3, 3 L4. In simple x-ray, findings were showed 13 cases (59.1%) in laminar fracture, 7 (31.8%) in posterior facet injury, 16 (72.7%) in inter-spinous widening and 8 (36.4%) in inter-spinous malalignment. In CT, findings were showed 13 (59.1%) in laminar fracture, 10 (45.5%) in posterior facet injury, 9 (40.9%) in transverse process fracture. In MRI, findings were showed 18 (81.8%) in posterior inter-spinous ligament injury and were not showed dural tear. The combined cases of posterior bony and ligamentous injury was 6 (27%) and 5 of 6 showed dural tear and the analysis of dural tear and radiologic findings was showed positive correlation (p=0.004).
CONCLUSION
Posterior ligament injury was more frequent than bony injury in unstable burst fracture. Among the posterior bony injuries, dural tear was more frequent in facet injury. Authors confirmed all dural tear with operation. In cases of posterior bony injury combined with ligamentous injuries, the possibility of dural tear was significantly higher than that of single structural injury (p=0.004).

Citations

Citations to this article as recorded by

Lumbar Spine Fracture
Seung-Wook Back, Hyun-Joong Cho, Ye-Soo Park
Journal of the Korean Fracture Society.2011; 24(3): 277. CrossRef
Relationship between Lamina Fractures and Dural Tear in Low Lumbar Burst Fractures
Ki-Chan An, Dae Hyun Park, Yong-Wook Kwon
Journal of the Korean Fracture Society.2011; 24(3): 256. CrossRef

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