title: Bony flexion-distraction injury of the lower lumbar spine treated with instrumentation without fusion and early implant removal: a method of treatment to preserve lumbar motion: two-year follow-up of a teenage patient.
abstract: Most single level bony flexion-distraction injuries can be treated in a brace. Internal fixation is required, however, when a patient fails brace treatment. Instrumentation is routinely left in place for a year or more and in an unfused spine can lead to early degenerative changes of the facets and disks. Implant removal once healing has occurred can preserve motion segments in the lumbar spine and offer an advantage in a young patient over instrumentation and fusion. A case report is presented of a 17-year-old female treated successfully with internal fixation without fusion of a bony flexion-distraction injury of the lower lumbar spine with early implant removal and 2-year follow-up.
authors.affiliation: Orthopaedic Surgery Service, Madigan Army Medical Center, Tacoma, Washington 98431, USA. joe.eichinger@us.army.mil
authors.forename: Josef K
authors.initials: JK
authors.lastname: Eichinger
authors.forename: Edward D
authors.initials: ED
authors.lastname: Arrington
authors.forename: Glenn J
authors.initials: GJ
authors.lastname: Kerr
authors.forename: Robert
authors.initials: R
authors.lastname: Molinari
mesh_terms: D000293:Adolescent; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016268:Internal Fixators / Q000592:standards / Q000639:trends*; D004204:Joint Dislocations / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D019635:Neurosurgical Procedures / Q000295:instrumentation* / Q000379:methods; D011183:Postoperative Complications / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D019736:Prostheses and Implants / Q000592:standards / Q000639:trends*; D016059:Range of Motion, Articular / Q000502:physiology; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013128:Spinal Osteophytosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D013995:Time; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome