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Traumatic burst fracture in a patient with a lumbar artificial disc.

Publication ,  Journal Article
Gottfried, ON; Brodke, DS
Published in: J Neurosurg Spine
September 2009

Lumbar disc arthroplasty is now a common treatment for lumbar degenerative disc disease. Whereas the immediate and delayed complications in patients with artificial lumbar discs are well reported, the durability of artificial disc hardware after severe spine trauma is unknown. The authors describe the management of a rare case of a traumatic lumbar burst fracture in a patient who had undergone disc arthroplasty. This 31-year-old male contractor had undergone placement of an L4-5 Charité artificial disc (DePuy Spine) and L5-S1 anterior lumbar fusion 10 months before he fell from a roof and sustained a traumatic L-3 burst fracture with significant canal compromise and cauda equina injury. Despite the considerable compressive load on his spine, the artificial disc (L4-5) remained intact without any radiological signs of hardware failure, and the vertebrae above (L-4) and below (L-5) the artificial disc had no signs of injury. For the L-3 burst fracture the patient underwent an open decompressive laminectomy at L2-3 and posterior fusion with instrumentation from L-2 to L-4. At 24 months postinjury, he had returned to full work activities as a contractor with minimal back pain and mild right lower-extremity sensory changes and weakness left over from the trauma. The total disc arthroplasty at L4-5 is functional and has preserved motion, and there is a solid fusion at L2-4 and L5-S1. This case demonstrates that a lumbar artificial disc can tolerate a significant load from trauma and remain functional without hardware failure even after a traumatic burst fracture at the adjacent lumbar vertebral body and shows the successful treatment of this fracture, with posterior fusion preserving the motion of an artificial disc.

Duke Scholars

Published In

J Neurosurg Spine

DOI

ISSN

1547-5654

Publication Date

September 2009

Volume

11

Issue

3

Start / End Page

353 / 357

Location

United States

Related Subject Headings

  • Spinal Fusion
  • Spinal Fractures
  • Sacrum
  • Prostheses and Implants
  • Orthopedics
  • Male
  • Lumbar Vertebrae
  • Laminectomy
  • Intervertebral Disc
  • Humans
 

Citation

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Gottfried, O. N., & Brodke, D. S. (2009). Traumatic burst fracture in a patient with a lumbar artificial disc. J Neurosurg Spine, 11(3), 353–357. https://doi.org/10.3171/2009.3.SPINE08902
Gottfried, Oren N., and Darrel S. Brodke. “Traumatic burst fracture in a patient with a lumbar artificial disc.J Neurosurg Spine 11, no. 3 (September 2009): 353–57. https://doi.org/10.3171/2009.3.SPINE08902.
Gottfried ON, Brodke DS. Traumatic burst fracture in a patient with a lumbar artificial disc. J Neurosurg Spine. 2009 Sep;11(3):353–7.
Gottfried, Oren N., and Darrel S. Brodke. “Traumatic burst fracture in a patient with a lumbar artificial disc.J Neurosurg Spine, vol. 11, no. 3, Sept. 2009, pp. 353–57. Pubmed, doi:10.3171/2009.3.SPINE08902.
Gottfried ON, Brodke DS. Traumatic burst fracture in a patient with a lumbar artificial disc. J Neurosurg Spine. 2009 Sep;11(3):353–357.

Published In

J Neurosurg Spine

DOI

ISSN

1547-5654

Publication Date

September 2009

Volume

11

Issue

3

Start / End Page

353 / 357

Location

United States

Related Subject Headings

  • Spinal Fusion
  • Spinal Fractures
  • Sacrum
  • Prostheses and Implants
  • Orthopedics
  • Male
  • Lumbar Vertebrae
  • Laminectomy
  • Intervertebral Disc
  • Humans