Hyperextension fracture-dislocation of the thoracic spine with paraplegia in a patient with diffuse idiopathic skeletal hyperostosis.
The case is described of a hyperextension thoracic spine fracture in a patient with diffuse idiopathic skeletal hyperostosis (DISH). A 70-year-old woman awoke paraplegic after retroperitoneal surgery after having been positioned in the hyperextended axially rotated position. Imaging demonstrated a T9-10 fracture-dislocation with severe pressure on the spinal cord, as well as findings typical of DISH. This case emphasizes the danger inherent in manipulating the ankylosed hyperostotic spine. It is proposed that patients undergoing surgery in this position should be evaluated for DISH as an additional risk factor.
Israel
Z
Z
Department of Neurosurgery, Hadassah Hebrew University Hospital, Jerusalem, Israel.
Mosheiff
R
R
Gross
E
E
Muggia-Sullam
M
M
Floman
Y
Y
D000368:Aged; D005260:Female; D006801:Humans; D004057:Hyperostosis, Diffuse Idiopathic Skeletal / Q000150:complications*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000209:etiology*; D009192:Myelography; D010264:Paraplegia / Q000209:etiology*; D011183:Postoperative Complications; D011187:Posture; D012186:Retroperitoneal Neoplasms / Q000601:surgery*; D012399:Rotation; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology*; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed