Fractured Vertebrae Burst Fracture

Raymond not imperilled by Canucks' injury response

It was an awkward hit, but the Vancouver Canucks did not put Mason Raymond’s health in jeopardy by allowing him to skate off the ice rather than be taken off on a stretcher during Game 6, experts say.

Raymond suffered a vertebrae compression fracture when he was pushed backward into the boards while bent at the waist by Boston Bruins defenceman Johnny Boychuk in the first few seconds of Monday’s Game 6 of the Stanley Cup final, according to Canucks general manager Mike Gillis. The 25-year-old winger will likely miss three to four months.

There were questions about the severity of Raymond’s injury after he stayed on the ice for several minutes as trainers tended to him. He eventually skated off the ice with the help of two teammates and was taken to hospital on a stretcher.

Some have suggested Raymond was in no condition to stand or even move following the hit.

But many spinal experts and sports trainers say the team made a good call and that it was unlikely Raymond would risk further injury by getting up.

“Personally, I do think they handled it in the right way,” said Zhi Wang, a spinal surgeon at the Université de Montréal's Hospital Center. “These types of fractures are actually stable fractures. They do not have any neurological impact.”

Vertebrae compression fractures occur when a bone in the spine collapses. They are not considered spinal cord injuries, which range in severity, with the most worrisome type, known as “burst fractures,” increasing a person’s risk of long-term problems, including nerve damage and paralysis. People with burst fractures experience intense, excruciating pain, much different than the pain associated with compression fractures, experts say.

Dr. Michael MacKay of Winnipeg’s Legacy Sport Medicine clinic said that if Raymond had suffered a burst fracture in his spinal column, the situation would have been much worse.

“The bones would have broken in multiple places. His legs would have been burning or numb. It would have been different on the ice. He would be in a lot of pain.”

The NHL has decided not to suspend Boychuk for the hit, which enraged many Vancouver fans and prompted some experts to say the incident provides more evidence the league is too lax on violence.

“One shift of a millimetre, a couple millimetres, a centimetre and it injures the [spinal] cord and you get irreparable damage,” said Paul Echlin, a sports medicine specialist based in London, Ont. “He has a fracture and they’re lucky that something [more serious] doesn’t happen.

Ⅱ fixation system for thoracolumbar burst fracture analysis ...

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thoracolumbar fractures; internal fixation

thoracolumbar spine burst fracture is the most common type of injury can cause spinal cord, nerve root injury, needs surgery. I since June 2004 ~ April 2008 the use of GSS Ⅱ thoracic fixation system 22 cases of lumbar burst fractures with good results.

clinical data

1 General information

22 patients in this group, 18 males and 4 females; Age 24 to 50 years, mean 33 years old. cause of his injuries: 10 cases of injury falling from height, road traffic injuries in 8 cases, 4 cases of heavy injured. the injured area: T112 cases, T122 cases, L16 cases, L210 cases, L32 cases. reference burst fractures were Denis classification. 22 cases of nerve damage in varying degrees, according to Frankel grade: A grade 2 cases, B 2 cases, C 5 cases, D 8 cases, E-class in 5 cases. `All X ray before surgery patients were, CT examination, 15 patients with vertebral compression grade Ⅱ, 7 cases of vertebral compression level III; injured segments spinal canal stenosis in the normal capacity of 23% to 70% (average 45%). vertebra degree of stenosis more than 50% of its total area, 16 cases of spinal bone in 6 cases there are free.

2 surgical methods

prone position anesthesia, chest and both sides of the iliac Pillow to the abdomen before the hanging. (1) distraction by distraction device, in the upper and lower vertebral segments of the one vertebral body determined to follow Weinstein anatomical pedicle entry point, with a rongeur bite than screw entry point around the ridge, the entry point of the skin exposed cancellous bone. cone with the center hole entry point play in the sink hole. and then with a limit set of blunt head or the tip of the pedicle punch a cone pedicle screw cone Road, a depth of entry points to the vertebral body anterior cortex from 80% to 90%. pin tract opens, head of the probe with a probe with a ball screw channel walls are bone tunnel, turn screw to match the “U “type of pedicle screws, confirmed by X-ray machine perspective of pedicle screws in the correct position. (2) decompression, for the following L2 burst fracture and incomplete or complete paralysis, bone occupying spinal stenosis, damage and 10 to 14 days in those in front of the lateral posterior spinal decompression. resection of spinal vertebral lamina and the upper part of the lamina and inferior articular process to facilitate decompression. the removal of vertebral pedicle or the side partial medial half of both sides of the pedicle into the vertebral canal in front of the spinal cord caused by pressure probe the scope and nature of things. When distraction reduction fixation, the use of nerve dissection retractor sub-dural sac and spinal nerve root, use the special In addition to bone or curved Zaozao osteotome straight into the front of the front of the bone, so as to achieve the full relief in front. (3) into titanium bar, titanium rod to the length of the appropriate pre-curved to match the physiological curvature of the spine anastomosis, respectively, pedicle screw “U”-type groove, the titanium rod arched forward, close to the lamina, embedded blocks, installed outside the hexagonal nut, first tighten the nut at one end nailed with appropriate vertical distraction distraction device, according to thoracic curvature and reset as appropriate adjustment to compressed vertebral body and intervertebral space back to normal height, vertebral connections continuously without a break, and no kyphosis, then tighten another one end of the snail hat, the same way the other side of the pedicle screw distraction, and finally select the appropriate link to the length of the horizontal connecting rod screw-rod system. (4), bone grafting, decompression of the line by line is not a small articular process, vertebral board and intertransverse bone grafting; on the line who has been in decompression and intertransverse bone graft. postoperative care: Postoperative wound suction drainage for 24 to 48 hours, routine use of antibiotics, dehydration treatment for 3 days, 12 to 14 days of stitches. underwent 48 hours of straight leg raising exercise, to prevent nerve root adhesions, two weeks after back muscle exercise, 8 to 12 weeks in bed after surgery, waist Belt 3 months.

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