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Sacral fracture causing neurogenic bladder: a case report.

Sasaji T, Yamada N, Iwai K - Case Rep Med (2012)

Bottom Line: Three months after surgery, his bladder function recovered normally.One year after surgery, he returned to a normal daily life and had no complaints regarding urination.One-year postoperative CT showed the decompressed third sacrum without displacement.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Fukushima Rosai Hospital, 3-Numajiri, Tsuzura-machi, Uchigo, Iwaki 973-8403, Japan.

ABSTRACT
A 76-year-old man presented with a Denis Zone III sacral fracture after a traffic accident. He also developed urinary retention and perineal numbness. The patient was diagnosed with neurogenic bladder dysfunction caused by the sacral fracture. A computed tomogram (CT) revealed that third sacral lamina was fractured and displaced into the spinal canal, but vertebral body did not displace. The fracture lines began at the center of lamina and extended bilateraly. The fracture pattern was unique. The sacrum was osteoporosis, and this fracture may be based on osteoporosis. We performed laminectomy to decompress sacral nerve roots. One month after surgery, the patient was able to urinate. Three months after surgery, his bladder function recovered normally. One year after surgery, he returned to a normal daily life and had no complaints regarding urination. One-year postoperative CT showed the decompressed third sacrum without displacement.

No MeSH data available.


Related in: MedlinePlus

Preoperative magnetic resonance image. (a) Sagittal plane on a T1-weighted image and (b) sagittal plane on a T2-weighted image Third, fourth, and fifth sacral vertebral bodies showed low intensities on T1- and T2-weighted images.
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fig3: Preoperative magnetic resonance image. (a) Sagittal plane on a T1-weighted image and (b) sagittal plane on a T2-weighted image Third, fourth, and fifth sacral vertebral bodies showed low intensities on T1- and T2-weighted images.

Mentions: A sagittal reconstructed computed tomogram (CT) revealed that the third sacral lamina was fractured and displaced into the spinal canal. The posterior part of the third sacral vertebral body became hollow, but the sacral vertebral body did not displace (Figure 1(a)). An axial reconstructed CT revealed that the third sacral lamina was fractured bilaterally. The cortex of sacrum was thin. The trabeculae of the third sacral body were sparse (Figure 1(b)). These appearance suggested osteoporosis. A three-dimensional CT revealed oblique fracture lines, which began at the center of the third sacral lamina and extended bilaterally (Figure 2). The fracture lines were unique, and we suspected the fragility fracture based on osteoprosis. The fracture involved Zone II and III. In relevance to clinical symptoms, we diagnosed Denis Zone III sacral fracture. The vertebral body did not displace, and so we determined that this fracture was stable. Our operation plan was a decompression surgery without stabilization procedure. Sagittal planes of magnetic resonance imaging showed signal changes in the sacral vertebral bodies. The third, fourth, and fifth sacral vertebral bodies showed low intensities on T1- and T2-weighted images (Figures 3(a) and 3(b)). We interpreted these findings as microfracture.


Sacral fracture causing neurogenic bladder: a case report.

Sasaji T, Yamada N, Iwai K - Case Rep Med (2012)

Preoperative magnetic resonance image. (a) Sagittal plane on a T1-weighted image and (b) sagittal plane on a T2-weighted image Third, fourth, and fifth sacral vertebral bodies showed low intensities on T1- and T2-weighted images.
© Copyright Policy - open-access
Related In: Results  -  Collection

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fig3: Preoperative magnetic resonance image. (a) Sagittal plane on a T1-weighted image and (b) sagittal plane on a T2-weighted image Third, fourth, and fifth sacral vertebral bodies showed low intensities on T1- and T2-weighted images.
Mentions: A sagittal reconstructed computed tomogram (CT) revealed that the third sacral lamina was fractured and displaced into the spinal canal. The posterior part of the third sacral vertebral body became hollow, but the sacral vertebral body did not displace (Figure 1(a)). An axial reconstructed CT revealed that the third sacral lamina was fractured bilaterally. The cortex of sacrum was thin. The trabeculae of the third sacral body were sparse (Figure 1(b)). These appearance suggested osteoporosis. A three-dimensional CT revealed oblique fracture lines, which began at the center of the third sacral lamina and extended bilaterally (Figure 2). The fracture lines were unique, and we suspected the fragility fracture based on osteoprosis. The fracture involved Zone II and III. In relevance to clinical symptoms, we diagnosed Denis Zone III sacral fracture. The vertebral body did not displace, and so we determined that this fracture was stable. Our operation plan was a decompression surgery without stabilization procedure. Sagittal planes of magnetic resonance imaging showed signal changes in the sacral vertebral bodies. The third, fourth, and fifth sacral vertebral bodies showed low intensities on T1- and T2-weighted images (Figures 3(a) and 3(b)). We interpreted these findings as microfracture.

Bottom Line: Three months after surgery, his bladder function recovered normally.One year after surgery, he returned to a normal daily life and had no complaints regarding urination.One-year postoperative CT showed the decompressed third sacrum without displacement.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopedic Surgery, Fukushima Rosai Hospital, 3-Numajiri, Tsuzura-machi, Uchigo, Iwaki 973-8403, Japan.

ABSTRACT
A 76-year-old man presented with a Denis Zone III sacral fracture after a traffic accident. He also developed urinary retention and perineal numbness. The patient was diagnosed with neurogenic bladder dysfunction caused by the sacral fracture. A computed tomogram (CT) revealed that third sacral lamina was fractured and displaced into the spinal canal, but vertebral body did not displace. The fracture lines began at the center of lamina and extended bilateraly. The fracture pattern was unique. The sacrum was osteoporosis, and this fracture may be based on osteoporosis. We performed laminectomy to decompress sacral nerve roots. One month after surgery, the patient was able to urinate. Three months after surgery, his bladder function recovered normally. One year after surgery, he returned to a normal daily life and had no complaints regarding urination. One-year postoperative CT showed the decompressed third sacrum without displacement.

No MeSH data available.


Related in: MedlinePlus