Abstract
A 17-year-old young man presented with a highly unstable fracture dislocation of the third and fourth thoracic vertebrae with neurological deficit, in which the fractured spine had perforated the thoracic esophagus. Open reduction and internal fixation of the spinal fractures in combination with aggressive treatment of the mediastinitis caused by esophageal perforation, consisting of two re-thoracotomies, was performed. Two years after the accident, the patient had recovered well. The neurological deficit had recovered, and there were no difficulties with swallowing.
Key words: Anterior spinal fusion, Brown-Sequard, Esophageal perforation
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References
- 1.Agha FP. Esophageal perforation with fracture dislocation of the cervical spine due to hyperextension injury. Br J Radiol. 1982;55:369–372. doi: 10.1259/0007-1285-55-653-369. [DOI] [PubMed] [Google Scholar]
- 2.Anonymous (1985)Streptococcus milleri, pathogen in various guises. Lancet 11:1403 [PubMed]
- 3.Beal SL, Pottmeyer EW, Spisso JM. Esophageal perforation following external blunt trauma. J Trauma. 1988;28:1425–1432. doi: 10.1097/00005373-198810000-00003. [DOI] [PubMed] [Google Scholar]
- 4.Bohlman HH. Traumatic fractures of the upper thoracic spine with paralysis. In: Proceedings of the American Academy of Orthopaedic Surgeons. J Bone Joint Surg [Am] 1974;56:1299. [Google Scholar]
- 5.Chen JY, Chen WJ, Huang TJ, et al. Spinal epidural abscess complicating cervical spine fracture with hypopharyngeal perforation. A case report. Spine. 1992;17:971–974. doi: 10.1097/00007632-199208000-00018. [DOI] [PubMed] [Google Scholar]
- 6.Defore WW, Mattox KL, Hansen HA, et al. Surgical management of penetrating injuries of the esophagus. Am J Surg. 1977;134:734–738. doi: 10.1016/0002-9610(77)90313-0. [DOI] [PubMed] [Google Scholar]
- 7.Flynn AE, Verrier ED, Way LW, et al. Esophageal perforation. Arch Surg. 1989;124:1211–1215. doi: 10.1001/archsurg.1989.01410100117020. [DOI] [PubMed] [Google Scholar]
- 8.Loon JLM, Slot GH, Pavlov PW. Anterior instrumentation of the spine in thoracic and thoracolumbar fractures. The single rod versus the double rod Slot-Zielke device. Spine. 1996;21:734–740. doi: 10.1097/00007632-199603150-00015. [DOI] [PubMed] [Google Scholar]
- 9.Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S. A comprehensive classification of thoracic and lumbar injuries. Eur Spine J. 1994;3:184–201. doi: 10.1007/BF02221591. [DOI] [PubMed] [Google Scholar]
- 10.McAffee PC, Bohlman HH, Yuan HA. Anterior decompression of traumatic thoracolumbar fractures with incomplete neurological deficit using a retroperitoneal approach. J Bone Joint Surg [Am] 1985;67:89–104. [PubMed] [Google Scholar]
- 11.Pieron AP. Halo traction (in Dutch) Ned Tijdschr Geneeskd. 1971;115:2124–2126. [PubMed] [Google Scholar]
- 12.Pollock RA, Apple DF, Purvis JM, et al. Esophageal and hypopharyngeal injuries in patients with cervical spine trauma. Ann Otol. 1988;90:323–327. doi: 10.1177/000348948109000406. [DOI] [PubMed] [Google Scholar]
- 13.Reddin A, Mirvis SE, Diaconis JN. Rupture of the cervical esophagus and trachea associated with cervical spine fracture. J Trauma. 1987;27:564–566. doi: 10.1097/00005373-198705000-00018. [DOI] [PubMed] [Google Scholar]
- 14.Schneider RC (1952) The syndrome of acute anterior spinal cord injury. Symposium on Trauma at the Clinical Congress of the American College of Surgeons, New York City, September 25
- 15.Spenler CW, Benfield JR. Esophageal disruption from blunt and penetrating external trauma. Arch Surg. 1976;111:663–667. doi: 10.1001/archsurg.1976.01360240043007. [DOI] [PubMed] [Google Scholar]
- 16.Tomaszek DE, Rosener MJ. Occult esophageal perforations associated with cervical spine fracture. Neurosurgery. 1984;14:492–494. [PubMed] [Google Scholar]
