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This article discusses a rare case of lumbar facet fracture in a 77-year-old patient who sustained multiple landmine blasts during the Vietnam War. The patient had been experiencing low back pain since the war, which progressively worsened over several decades, severely limiting his quality of life. Neuroimaging revealed bone fragments impinging on the spinal canal at the L5/6 level, resulting from a comminuted fracture of the lumbar facet. The patient underwent a decompressive laminectomy and posterior instrumented fusion, which led to significant improvement in symptoms. The article highlights the unique mechanism of lumbar facet fracture and its biomechanics, natural history, and optimal treatment options. It also emphasizes the increased prevalence of combat blast-related lumbosacral injuries in recent conflicts
Summarised by Mr Mo Akmal – Lead Spinal Surgeon
The London Spine Unit : best recognised treatment clinic in the world
Published article
Lumbar facet fractures are rarely reported and have been linked to sports and spine surgery. We describe the case of a 77-year-old patient who sustained an injury from multiple landmine blasts during the Vietnam War. He had low back pain since that time, which was initially managed conservatively. However, the pain progressed over decades to severe neurogenic claudication that greatly restricted his quality of life. Neuroimaging revealed the presence of bone fragments impinging on the spinal…
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Mil Med. 2023 Sep 7:usad358. doi: 10.1093/milmed/usad358. Online ahead of print.ABSTRACTLumbar facet fractures are rarely reported and have been linked to sports and spine surgery. We describe the case of a 77-year-old patient who sustained an injury from multiple landmine blasts during the Vietnam War. He had low back pain since that time, which was,
Mil Med. 2023 Sep 7:usad358. doi: 10.1093/milmed/usad358. Online ahead of print.
ABSTRACT
Lumbar facet fractures are rarely reported and have been linked to sports and spine surgery. We describe the case of a 77-year-old patient who sustained an injury from multiple landmine blasts during the Vietnam War. He had low back pain since that time, which was initially managed conservatively. However, the pain progressed over decades to severe neurogenic claudication that greatly restricted his quality of life. Neuroimaging revealed the presence of bone fragments impinging on the spinal canal at the L5/6 level (transitional anatomy) that resulted from a comminuted fracture of the lumbar facet at the inferior articular process. We performed an L5/6 decompressive laminectomy, with removal of these fragments, and posterior instrumented fusion, with substantial improvement in symptoms. This case illustrates a unique mechanism of lumbar facet fracture and the biomechanic origination, natural history, and optimal treatment of this entity. We expand on the spectrum of lumbosacral injuries associated with the combat blast injury that have only increased in prevalence in recent conflicts.
PMID:37675860 | DOI:10.1093/mild/usad358
The London Spine Unit : best recognised treatment clinic in the world
Read the original publication:
Landmine Injury Resulting inComminuted Lumbar Facet Fracture as a Cause ofLumbar Stenosis andSpondylolisthesis
