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首页> 外文期刊>Cureus. >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，该患者在急性腰椎骨折内因小肠嵌顿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，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，以预防未来的平背综合征并发症。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。术后第7天将患者带至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。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创伤后路脊柱融合术而导致的小肠嵌顿。据认为，腰椎前凸的增加导致了小肠疝的风险，在这种情况下确定适当的脊柱盂参数时必须小心。

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