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首页> 美国卫生研究院文献>other >Delayed Small Bowel Incarceration Within a Lumbar Burst Fracture After Posterior Spinal Fusion: A Case Report
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Delayed Small Bowel Incarceration Within a Lumbar Burst Fracture After Posterior Spinal Fusion: A Case Report

机译：脊柱后路融合术后腰椎爆裂性骨折延迟小肠嵌顿：一例报告

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摘要

We present a case report of a patient who had delayed small bowel obstruction secondary to an incarcerated loop of small bowel within an acute lumbar spine fracture. The patient was involved in a rollover motor vehicle accident, resulting in lumbar spine fractures at L2-4. A comminuted fracture of the L3 vertebral body with likely disruption of the anterior longitudinal ligament (ALL) was noted. The patient underwent L1-4 posterior spinal fusion with the introduction of mild lumbar lordosis to prevent future complications of flatback syndrome. On postoperative Day 4, the patient was noted to have signs and symptoms of progressive small bowel obstruction. Conservative management was initiated with minimal improvement. The patient was taken to the operating room on postoperative Day 7 for an exploratory laparotomy. A necrotic loop of small bowel was noted to be entrapped in the ventral L3 vertebral body defect. This bowel was released and resected, with side-to-side anastomosis performed. No previous cases describe small bowel incarceration because of posterior spinal fusion for trauma. The introduction of increased lumbar lordosis is thought to have contributed to this risk of small bowel herniation, and care must be taken when determining appropriate spinopelvic parameters in these cases.
机译：我们提出一例患者的报告，该患者因急性腰椎骨折内小肠嵌顿loop继发于小肠梗阻。该患者卷入翻车事故，导致腰椎在L2-4骨折。注意到L3椎体粉碎性骨折并可能破坏了前纵韧带（ALL）。该患者接受了L1-4后路脊柱融合术，并引入了轻度腰椎前凸，以防止将来出现平背综合征的并发症。术后第4天，患者被发现有进行性小肠梗阻的体征和症状。保守的管理开始以最小的进步。该患者在术后第7天被带到手术室进行探查性剖腹手术。小肠坏死环被困在腹侧L3椎体缺损中。该肠被释放并切除，并进行了侧向吻合。以前没有病例描述过因后路脊柱融合术而导致小肠嵌顿。腰椎前凸增加的引入被认为导致了小肠疝的风险，在这些情况下确定适当的脊柱骨盆参数时必须小心。

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