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Traumatic hyperextension-distraction injuries of the thoracolumbar spine: a technical note on surgical positioning

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AbstractPurposeHyperextension-distraction type injury of the thoracolumbar spine is an unstable fracture pattern that generally necessitates surgical stabilization by posterior instrumentation. Care must be taken when positioning these patients from supine… Click to show full abstract

AbstractPurposeHyperextension-distraction type injury of the thoracolumbar spine is an unstable fracture pattern that generally necessitates surgical stabilization by posterior instrumentation. Care must be taken when positioning these patients from supine to prone due to the unstable nature of their injury. The study objectives were (1) to describe a novel modification of the Jackson table turn technique, which may be safer and more effective than the conventional log-roll method and traditional Jackson table technique for positioning patients with hyperextension-distraction injuries of the thoracolumbar spine from supine to prone in the operating room and (2) to present two cases in which this technique was successfully performed.MethodsTwo patients were carefully positioned from supine to prone by our modification of the Jackson table turn technique, which utilizes a Wilson frame sandwiched between two flat-top Jackson frames. Case 1: a 65-year-old female presented status-post motor vehicle collision with a T9–T10 extension-distraction injury, requiring T7–T12 posterior spinal instrumented fusion (PSIF). Case 2: a 72-year-old female presented status-post motor vehicle collision with a T9–T10 extension-distraction injury and an unstable L1 burst fracture, requiring T7–L2 PSIF. ResultsBoth patients remained hemodynamically stable and neurologically intact throughout positioning and postoperatively.ConclusionsThis technique is safe and effective for positioning patients with hyperextension-distraction type injuries of the thoracolumbar spine from supine to prone in the operating room and may be superior to conventional methods.Graphical abstractThese slides can be retrieved under Electronic Supplementary Material.

Keywords: thoracolumbar spine; injuries thoracolumbar; supine prone; distraction; hyperextension distraction

Journal Title: European Spine Journal
Year Published: 2019

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