Biomechanics of the Thoracic and Lumbar Spine
Normal biomechanics of the spine is characterized by the fact that several joints must be balanced at the same time. Between any two adjacent vertebrae, the equilibrium in the intervertebral disc and the joints of the vertebral arches is to be maintained
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Editor-in-Chief: R. P. Vigouroux Volume 2
Thoracic and Lumbar Spine and Spinal Cord Injuries Managing Editor: Ph. Harris
Editorial Board: J. C. Christensen G. J. Dohrmann
S. El-Gindi
J. W. Glowacki
B. Ramamurthi
Advisory Board: P. L. G. P.
Albert Lasierra Atkinson Belanger Benedek J. Berney A. Bou-Salah R. Braakman A. Bricolo
M. Costa! G. Foroglou R. A. Frowein R. L. M cLaurin N. Nakamura V. Novaes /. Oprescu
A. Rakotobe A. Rocha E Melo A. Sahar M. Sambasivan D. Stalhammer G. K. Vande1jield A. de Vasconcellos Marques
Springer-Verlag Wien GmbH
Professor ROBERT P. VIGOUROUX Clinique Neuro-chirurgicale, C.H.U. Timone, Marseille, France PHILLIP HARRIS, F.R.C.S.E., F.R.C.P.E., F.R.C.S. (Glas.), F.R.S.E., Consultant Neurosurgeon, Department Surgical Neurology, Western General Hospital, Edinburgh, Scotland
Produci Liability: The publisher can give no guarantee for information about drug dosage and application thereof contained in this book. In every individual case the respective user must check its accuracy by consulting other pharmaceutical literature
This work is subject to copyright Ali rights are reserved, whether the whole or part of the material is concerned, specifically those of translation, reprinting, re-use of illustrations, broadcasting, reproduction by photocopying machi ne or similar means, and storage in data banks ยท.1':: 1987 by Springer-Verlag Wien
Originally published by Springer-Verlag Wien New York in 1987
With 64 Figures
ISSN 0178-3696 ISBN 978-3-7091-4145-8 ISBN 978-3-7091-4143-4 (eBook) DOI 10.1007/978-3-7091-4143-4
Foreword Owing to their frequency and possible consequences and considering the fact they frequently affect young people, trauma tic lesions of the thoracolumbar spine represent a special point of interest within the field of Neurotraumatology. Traffic accidents are the commonest cause, which accounts for the high peak of occurrence between 15 and 24 years of age. It is also worth noting that according to published series nearly 50% ofthe cases affect the thoraco-lumbar junction. From an anatomical point of view, we must note the severity of thoracic spinal cord lesions especially of the thoraco-lumbar junction and of the lumbar region and be able to associate injuries ofthe conus medullaris and of the cauda equina where there is a possibility of neurological recovery. Clinical evaluation is not always easy, but remains the basis for diagnosis and prognosis. The neurological classification proposed by FRANKEL et al. in 1969 and used at STOKE MANDEVILLE Hospital seems to retain its value. A more sophisticated study of medullary evoked potentials, as described by TsUBOKAWA can allow a more precise localisation and appreciation of the extent ofthe lesion as well as a better evaluation ofthe prognosis and ofthe evaluation of treatment in the acute phase. The neuro-radiological study should include standard views ofthe whole of the spine with antero-posterior and lateral tomograms of the fractured or luxated area. At present, the unquestionable contribution of the CT. Sca
