Skip to main content

Advertisement

Log in

Extension type fracture of the ankylotic thoracic spine with gross displacement causing esophageal rupture

  • Case Report
  • Published:
European Spine Journal Aims and scope Submit manuscript

Abstract

Purpose

This study aimed at discussing the relevance of the type B3 fracture of the new AOSpine classification.

Methods

Hyperextension fractures of the spine are rare in the general population, but common in the ankylotic spine. We present a case of a severe spinal fracture with concomitant esophageal rupture, which was diagnosed early and could be treated during the initial trauma care.

Results

The spinal column was stabilized using a percutaneous technique after which the perforated esophagus was sutured through a thoracotomy. The spinal injury was classified a type B3 fracture using the new AOSpine classification.

Conclusion

The B3 typification raised a lot of discussion during the development of the new classification system and may be controversial. This case, however, nicely illustrates the relevance of an intact posterior hinge as compared to C-type injuries where complete dissociation is present with inherent spinal cord damage.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Westerveld LA, Verlaan JJ, Oner FC (2009) Spinal fractures in patients with ankylosing spinal disorders: a systematic review of the literature on treatment, neurological status and complications. Eur Spine J 18:145–156

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Westerveld LA, van Bemmel JC, Dhert WJA, Oner FC, Verlaan JJ (2014) Clinical outcome after traumatic spinal fractures in patients with ankylosing spinal disorders compared with control patients. Spine J 14:729–740

    Article  CAS  PubMed  Google Scholar 

  3. Kiss C, Szilágyi M, Paksy A, Poór G (2002) Risk factors for diffuse idiopathic skeletal hyperostosis: a case–control study. Rheumatology (Oxford) 41:27–30

    Article  CAS  Google Scholar 

  4. Denko CW, Malemud CJ (2006) Body mass index and blood glucose: correlations with serum insulin, growth hormone, and insulin-like growth factor-1 levels in patients with diffuse idiopathic skeletal hyperostosis (DISH). Rheumatol Int 26:292–297

    Article  CAS  PubMed  Google Scholar 

  5. Weinfeld RM, Olson PN, Maki DD, Griffiths HJ (1997) The prevalence of diffuse idiopathic skeletal hyperostosis (DISH) in two large American Midwest metropolitan hospital populations. Skeletal Radiol 26:222–225

    Article  CAS  PubMed  Google Scholar 

  6. Kim S-K et al (2004) The prevalence of diffuse idiopathic skeletal hyperostosis in Korea. J Rheumatol 31:2032–2035

    PubMed  Google Scholar 

  7. Smyth S, Heron A (2006) Diabetes and obesity: the twin epidemics. Nat Med 12:75–80

    Article  CAS  PubMed  Google Scholar 

  8. World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ. Tech. Rep. Ser. 894:i–xii, 1–253

  9. Magerl F, Aebi M, Gertzbein SD, Harms J, Nazarian S (1994) A comprehensive classification of thoracic and lumbar injuries. Eur Spine J 3:184–201

    Article  CAS  PubMed  Google Scholar 

  10. Reinhold M et al (2013) AO spine injury classification system: a revision proposal for the thoracic and lumbar spine. Eur Spine J 22:2184–2201

    Article  PubMed  PubMed Central  Google Scholar 

  11. Chapman JR, Agel J, Jurkovich GJ, Bellabarba C (2008) Thoracolumbar flexion-distraction injuries: associated morbidity and neurological outcomes. Spine (Phila Pa 1976) 33:648–657

    Article  Google Scholar 

  12. Nakai S, Yoshizawa H, Kobayashi S, Miyachi M (1998) Esophageal injury secondary to thoracic spinal trauma: the need for early diagnosis and aggressive surgical treatment. J Trauma 44:1086–1089

    Article  CAS  PubMed  Google Scholar 

  13. Cherveniakov A, Cherveniakov P (1992) Surgical treatment of acute purulent mediastinitis. Eur J Cardiothorac Surg 6:407–410 (discussion 411)

    Article  CAS  PubMed  Google Scholar 

  14. Uhrenholt L et al (2011) Esophageal injury in fatal rear-impact collisions. Forensic Sci Int 206:e52–e57

    Article  PubMed  Google Scholar 

  15. Tjardes T, Wafaizadeh A, Steinhausen E, Krakamp B, Bouillon B (2009) Extension injury of the thoracic spine with rupture of the oesophagus and successful conservative therapy of concomitant mediastinitis. Eur Spine J 18(Suppl 2):240–244

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F. R. J. Groen.

Ethics declarations

Conflict of interest

None of the authors has any potential conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Groen, F.R.J., Delawi, D., Kruyt, M.C. et al. Extension type fracture of the ankylotic thoracic spine with gross displacement causing esophageal rupture. Eur Spine J 25 (Suppl 1), 183–187 (2016). https://doi.org/10.1007/s00586-015-4315-1

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00586-015-4315-1

Keywords

Navigation