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Posterior Fixation of a Cervical Fracture Using the RRS Loop Spine System and Polyethylene Tape in an Elderly Ankylosing Spondylitis Patient: A Case Report.

Koizumi M, Iida J, Shigematsu H, Satoh N, Tanaka M, Kura T, Tsukamoto S, Kato Y, Tanaka Y - Asian Spine J (2012)

Bottom Line: An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling.Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level.To our knowledge, this is the first report of an application of the RRS Loop Spine System to an ankylosing spondylitis patient with a cervical fracture.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan.

ABSTRACT
An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling. Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level. Posterior fixation from the occi pit to T3 was performed using the RRS Loop Spine System and concomitant polyethylene tape fixation. This system is characterized by the uniqueness of how it screws to the occi pit and its use of a fixation rod with a larger diameter than in other instrumentation devices for use in the cervical region. Sublaminar banding using polyethylene tape was used to secure fixation. Her postoperative course was unremarkable, and her neck pain was relieved, although neurological improvement was minor. To our knowledge, this is the first report of an application of the RRS Loop Spine System to an ankylosing spondylitis patient with a cervical fracture.

No MeSH data available.


Related in: MedlinePlus

A plain radiograph taken before Halo-vest immobilization shows a fracture in her cervical spine.
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Figure 1: A plain radiograph taken before Halo-vest immobilization shows a fracture in her cervical spine.

Mentions: An 80-year-old woman presented with neck pain and moderate paraparesis of Frankel grade C after falling on stairs. A plain radiograph revealed a fracture of an ossified anterior longitudinal ligament at the C3-4 level with marked osteoporosis of the cervical spine and ossification of each disc, making the border between the endplate and disc unclear (Fig. 1). Computed tomography showed the fracture line more clearly, indicating a fracture of the posterior longitudinal ligament at the C4-5 level, and an ossification mass that was encroaching on the spinal canal at the C3 to C4 level was identified (Fig. 2). A plain radiograph of the sacroiliac joint showed complete ankylosis and typical features of bamboo spine of the lumbar column that were consistent with AS. The patient's neurological status did not change despite improved cervical alignment at the fracture site and neck pain relief after Halo immobilization. These neurological deficits were a burden due to the elderly and paralytic status of this patient and caused diminished motivation and nocturnal delirium. Moreover, poor adaptation to the Halo-vest due to the patient's thoracic kyphosis and scoliosis led to a decubitus ulcer formation on her back. As a result of these conditions, surgery was selected as the treatment strategy.


Posterior Fixation of a Cervical Fracture Using the RRS Loop Spine System and Polyethylene Tape in an Elderly Ankylosing Spondylitis Patient: A Case Report.

Koizumi M, Iida J, Shigematsu H, Satoh N, Tanaka M, Kura T, Tsukamoto S, Kato Y, Tanaka Y - Asian Spine J (2012)

A plain radiograph taken before Halo-vest immobilization shows a fracture in her cervical spine.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3302918&req=5

Figure 1: A plain radiograph taken before Halo-vest immobilization shows a fracture in her cervical spine.
Mentions: An 80-year-old woman presented with neck pain and moderate paraparesis of Frankel grade C after falling on stairs. A plain radiograph revealed a fracture of an ossified anterior longitudinal ligament at the C3-4 level with marked osteoporosis of the cervical spine and ossification of each disc, making the border between the endplate and disc unclear (Fig. 1). Computed tomography showed the fracture line more clearly, indicating a fracture of the posterior longitudinal ligament at the C4-5 level, and an ossification mass that was encroaching on the spinal canal at the C3 to C4 level was identified (Fig. 2). A plain radiograph of the sacroiliac joint showed complete ankylosis and typical features of bamboo spine of the lumbar column that were consistent with AS. The patient's neurological status did not change despite improved cervical alignment at the fracture site and neck pain relief after Halo immobilization. These neurological deficits were a burden due to the elderly and paralytic status of this patient and caused diminished motivation and nocturnal delirium. Moreover, poor adaptation to the Halo-vest due to the patient's thoracic kyphosis and scoliosis led to a decubitus ulcer formation on her back. As a result of these conditions, surgery was selected as the treatment strategy.

Bottom Line: An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling.Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level.To our knowledge, this is the first report of an application of the RRS Loop Spine System to an ankylosing spondylitis patient with a cervical fracture.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Nara, Japan.

ABSTRACT
An 80-year-old woman presented with neck pain and paraparesis of Frankel C in her upper and lower extremities after falling. Imaging revealed an ankylosing cervical spine and a fracture line running obliquely from the anterior C3-4 to the posterior C4-5 level. Posterior fixation from the occi pit to T3 was performed using the RRS Loop Spine System and concomitant polyethylene tape fixation. This system is characterized by the uniqueness of how it screws to the occi pit and its use of a fixation rod with a larger diameter than in other instrumentation devices for use in the cervical region. Sublaminar banding using polyethylene tape was used to secure fixation. Her postoperative course was unremarkable, and her neck pain was relieved, although neurological improvement was minor. To our knowledge, this is the first report of an application of the RRS Loop Spine System to an ankylosing spondylitis patient with a cervical fracture.

No MeSH data available.


Related in: MedlinePlus