Seat Belt Syndrome With Cauda Equina Syndrome Two Unique Cases in the Same Motor Vehicle Accident

作者：Lin Muh Shi; Lin Hsin Ying; Hung Kuo Sheng; Lin Tien Jen; Wang Yao Chin; Chiu Wen Ta; Kung Woon Man^*

来源：Spine, 2013, 38(25): E1624-E1627.

DOI：10.1097/01.brs.0000435023.57940.43

• seat belt syndrome
• retropulsed canal fragment
• burst fracture
• cauda equina syndrome

Study Design. Case report. %26lt;br%26gt;Objective. To describe the surgical technique and outcome of 2 cases of lap-shoulder belt injury involving burst fracture at L5 and cauda equina syndrome (CES). %26lt;br%26gt;Summary of Background Data. Lap-shoulder belts have largely replaced lap belts in the front seats of cars, and therefore the concept of seat belt injury needs re-evaluation. %26lt;br%26gt;Methods. Two adults, the driver and front seat passenger in the same car involved in a collision, sustained lap-shoulder belt injury. One developed L5 Denis type A burst fracture and the other developed L5 Denis type B burst fracture. Both had CES. They were surgically managed by decompression of the spinal canal, which included removal of retropulsed fragments without impacting them. Both patients received short-segment transpedicle screws and rod system instrumentation without the fractured vertebra being included. %26lt;br%26gt;Results. The percentage of preoperative degree of canal displacement of the retropulsed fragment was 60% in one patient and 55% in the other based on computed tomography. The mechanism of injury in both patients might be axial loading. After surgical intervention, the CES including lower leg weakness/numbness and bladder/bowel dysfunction clinically improved in both patients. %26lt;br%26gt;Conclusion. Two adults in the same car involved in a collision were wearing lap-shoulder belts, and 1 had Denis type A burst fracture at L5 and the other had Denis type B burst fracture at L5. Both developed CES after the accident. Both patients had a good clinical outcome after surgical treatment.

• 出版日期2013-12-1