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Файл:Ординатура / Хирургия / Библиотека им академика М.И. Перельмана / Книга_6040_Библиотеки_им_академика_М_И_Перельмана.pdf
180 C. Potente et al.
Fig. 2 a–c. STIR sagittal (a), FSE fat sat T2 sagittal (b) and axial (c). Interspinous L2–L3 gap and opening of
interapophyseal articulations in traumatic hyper-flexion. Complete rupture of L2–L3 yellow and interspinous
ligaments. Posterior L2–L3 disk detachment from L3 with probably rupture of posterior longitudinal ligament
Case 54 - Traumatic Lumbar Dislocation. Percutaneous Stabilization 181
Postoperative Follow-Up After 1 Month
Fig. 3 a–b. FSE T2
sagittal a axial. b L2–L3
vertebral stabilization
through transpeduncular
screws and posterior
metallic bars. Regular
alignment and reduction of
interspinous gap
Cervical Traumatic Dislocation Stabilization, Canal Decompression and Diskectomy
Regular Findings
Alessandro Stecco, Silvio Ciolfi, Francesco Fabbiano,
Christian Cossandi, Giuliana Fini, Gabriele Panzarasa
and Alessandro Carriero
• Patient with grade II C5–C6 anterior traumatic listesis treated by
• CT/MR preoperative imaging and postoperative follow-up
Preoperative Imaging
Case
55
stabilization through metallic screws, anterior decompression,
diskectomy and intervertebral C5–C6 mesh positioning
Fig. 1 a–c. CT axial (a–b) and MPR sagittal (c). Anterior C5–C6 II grade listesis with intracanal bone fragment.
Further bone fragment is anteriorly displaced. Arthrosis
A. Stecco (&) S. Ciolfi F. Fabbiano G. Fini A. Carriero
Department of Radiology, Maggiore della Carità University Hospital, Novara, Italy
e-mail: a.stecco@libero.it
A. Carriero
e-mail: procarriero@virgilio.it
C. Cossandi G. Panzarasa
Department of Neurosurgery, Maggiore della Carità University Hospital, Novara, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_60, Springer-Verlag Italia 2014
183
184 A. Stecco et al.
Postoperative Follow-Up (1st Surgery)
Fig. 2 a–b. FSE T2 (a) STIR sagittal (b). Stabilization and regular spine alignment. T2 spinal cord hyperintensity in
C5–C6 due to compression by median disk hernia and by yellow ligaments and interapophyseal articulations
hypertrophy
Postoperative Follow-Up (Re-surgery)
Fig. 3 a–b. CT axial (a) and MPR sagittal (b). Diskectomy and C5–C6 intervertebral mesh positioning. Regular
alignment and positioning of mesh and metallic screws
Traumatic Cervical
Fracture-Dislocation
Conservative Treatment
Delayed Impaired Consolidation
Achille Marotta, Domenico Cicala, Carmen Castagnolo,
Luca Brunese and Ferdinando Caranci
• Patient with C7–D1 fracture/dislocation (fell out of bed) conserva-
• CT/MR pre-treatment imaging and follow-up after 2 and 4 months
Pre-treatment Imaging
Case
56
tively treated by cervical collar (stabilization not possible for clinical
conditions)
Fig. 1 a–f.SET1(a–b), FSE T2 (c–d), STIR (e–f) sagittal sections
C7–D1 fracture-dislocation (peduncle/lamina). C6–D1 edema with related disk T2 hyperintensity;
small epidural hematoma (arrow), pre- and retrovertebral edema due to ligament distraction (STIR).
No signal alteration of spinal cord.
F. Caranci (&)
Advanced Biomedical Sciences Department, Unit of Neuroradiology, ‘‘Federico II’’ University, Naples, Italy
e-mail: ferdinandocaranci@libero.it
A. Marotta D. Cicala C. Castagnolo
Unit of Diagnostic Imaging, Villa Fiorita Clinic, Capua, CE, Italy
L. Brunese
Department of Health Science, Chair of Radiology, University of Molise, Campobasso, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_61, Springer-Verlag Italia 2014
185
186 A. Marotta et al.
Follow-Up After 2 Months of Conservative Treatment
C6–C7 structural collapse with irregular endplates.
Fig. 2 a–f.SET1(a–b), FSE T2 (c–d), STIR (e–f) sagittal sections. Reabsorption of epidural hematoma at C7–D1;
C6–C7 eight reduction and anterior wedging. C5–C7 edema
Fig. 3 a–b. MPR CT reconstructions. Bone morphologic abnormalities are more clearly depicted, with C5–C7
collapse and C6–C7 anterior wedging
Case 56 - Traumatic Cervical Fracture-Dislocation. Conservative Treatment 187
Follow-Up After 4 Months
C5–C7 collapse, unchanged remaining findings.
Fig. 4 a–f.SET1(a–b), FSE T2 (c–d), STIR (e–f) sagittal sections. Signal alteration improvement, no further
collapses. Persisting instability with C7–D1 dislocation, C6 retrolisthesis with cord compression
Fig. 5 a–d. MPR CT sagittal reconstructions
Traumatic Cervical Dislocation and Fracture Anterior Stabilization
Regular Findings
Tommaso Scarabino, Michela Capuano, Roberto Stanzione,
Carmine Iaffaldano and Michele Santoro
• Patient with C6–C7 traumatic dislocation and fracture at first
• Preoperative imaging and early XR postoperative follow-up
Preoperative Imaging
Fig. 1 a–k. CTaxial (a–f),
MPR sagittal (g–h), SE T1
(i), FSE T2 (j), STIR (k).
C6-C7 fracture and
dislocation with
involvement of peduncles,
transverse processes and
C6.Epidural hematoma
starting from C7 (i–k)
C7-D1 soft tissue
thickening due to anterior
logitudinal alligament
lesion (j–k). Disk
involvement with STIR
hyperintensity (k)
Case
57
conservatively and then treated by anterior stabilization (anterior
plate fixed by screws at C6–C7)
T. Scarabino (&) M. Capuano R. Stanzione
Department of Radiology—Neuroradiology, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
e-mail: tscarabino@hotmail.com
C. Iaffaldano M. Santoro
Department of Neurosurgery, ‘‘Lorenzo Bonomo’’ Hospital, Andria, Italy
T. Scarabino and S. Pollice (eds.), Imaging Spine After Treatment,
DOI: 10.1007/978-88-470-5391-5_62, Springer-Verlag Italia 2014
189
190 T. Scarabino et al.
Fig. 1 (continued)
Post-Treatment Conservative Follow-Up
Fig. 2 a–d. XR pre-
surgery (a), MPR sagittal
CT (b), SE T1 (c), and FSE
T2 (d). Regular alignment
after C6-C7 conservative
treatment
Case 57 - Traumatic Cervical Dislocation and Fracture. Anterior Stabilization 191
Fig. 2 (continued)
Early Postoperative Follow-Up
Fig. 3 a–b. XR antero-
posterior (a), and lateral
(b). C6-C7 anterior
stabilization