[Fracture dislocation of the thoracolumbar spine in pregnant patient: diagnostic by image and treatment].
BACKGROUND
Fracture dislocations of the thoracolumbar spine are, to a great extent, associated with neurologic deficit and instability, so a large percentage of them require surgical treatment. Being pregnant does not rule out the possibility of having this type of lesions. There are only a few bibliographic references concerning these cases and medical and treatment ignorance about them is frequent.


OBJECTIVE
Present a review of concepts and specifications for the correct and safe imaging diagnosis as well as considerations on the surgical treatment of patients with traumatic thoracolumbar spine lesions who are pregnant.


METHODS
A bibliographic review will be presented together with a clinical case of the CALRM, a 31-year-old female with a fracture dislocation at T12-L1, ASIA E, who at the time of the lesion was nine weeks pregnant, and was managed with a multidisciplinary approach that included the following services: Obstetrics and Gynecology, Pediatrics, Anesthesiology, Radiology and Imaging, Legal Medicine, Spine Surgery, and the hospital's Ethics Committee.


RESULTS
The diagnosis and characteristics of the lesion were assessed properly with standard X-rays and the support of MRI. The patient underwent posterior stabilization with a transpedicular system while she was pregnant, and bone graft harvesting and application with an anterior approach after the pregnancy, without any complications.


CONCLUSIONS
The correct understanding of the nature of ionizing radiation allows using an acceptable dose range according to the study performed and the patient's gestational age. Any patient with a fracture dislocation of the thoracolumbar spine who can tolerate the procedure should be stabilized. Moreover, the fetal risks of the surgical and anesthetic procedure may be avoided with an appropriate selection of the technique and the anesthetic agents, as well as with continuous maternal and fetal monitoring.
Martínez-Padilla
Luis Alberto
LA
Hospital General La Villa, Secretaría de Salud del Distrito Federal. luismtz_ort@yahoo.com.mx
Santana-Reyna
Miguel Angel
MA
Díaz-Ruiz
Omar Simitrio
OS
Silva-Escalante
David
D
Dufoo-Olvera
Manuel
M
García-López
Oscar Felipe
OF
López-Palacios
José de Jesús
Jde J
Carranco-Toledo
Gabriel Alfonso
GA
Aburto-Trejo
José Antonio
JA
D000328:Adult; D003952:Diagnostic Imaging; D005260:Female; D006801:Humans; D004204:Joint Dislocations / Q000175:diagnosis / Q000628:therapy; D008159:Lumbar Vertebrae / Q000293:injuries*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000628:therapy; D016103:Spinal Fractures / Q000175:diagnosis / Q000628:therapy; D013904:Thoracic Vertebrae / Q000293:injuries*