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

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Title:	Seat Belt Syndrome With Cauda Equina Syndrome Two Unique Cases in the Same Motor Vehicle Accident
Authors:	Lin, MS (Lin, Muh-Shi) Lin, HY (Lin, Hsin-Ying) Hung, KS (Hung, Kuo-Sheng) Lin, TJ (Lin, Tien-Jen) Wang, YC (Wang, Yao-Chin) Chiu, WT (Chiu, Wen-Ta) Kung, WM (Kung, Woon-Man)
Contributors:	Dept Exercise & Hlth Promot
Keywords:	seat belt syndrome retropulsed canal fragment burst fracture cauda equina syndrome
Date:	2013-12-01
Issue Date:	2014-03-03 16:29:36 (UTC+8)
Abstract:	Study Design. Case report. 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). 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. 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. 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. 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.
Relation:	SPINE Volume: 38 Issue: 25 Pages: E1624-E1627
Appears in Collections:	[Department of Exercise and Health Promotion] journal articles

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