The Traumatic Vacuum Phenomenon at the Anterior Portion of the Spine: A Clue to Extensive Spinal Fracture

Youichi Yanagawa^1, , Ryosuke Takahashi², Ikuto Takeuchi¹ and Akira Itoi²

¹Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University

²Department of Orthopedics, Shizuoka Hospital, Juntendo University

Cite this paper

Youichi Yanagawa, Ryosuke Takahashi, Ikuto Takeuchi and Akira Itoi. The Traumatic Vacuum Phenomenon at the Anterior Portion of the Spine: A Clue to Extensive Spinal Fracture. American Journal of Medical Case Reports. 2020; 8(12):451-452. doi: 10.12691/AJMCR-8-12-4

Abstract

A sixty-seven-year-old man complained back pain after falling from a ladder. On arrival, he had no neurological deficits in either leg. Emergency truncal computed tomography (CT) demonstrated multiple rib fractures with lung contusion and air density at the anterior portion of the 12th thoracic spine with fracture of the spinous process. Magnetic resonance imaging demonstrated an area of high intensity at the anterior portion of the 10 and 11th thoracic spine with the posterior portion of the 11 and 12th thoracic spine, suggesting extensive unstable lower thoracic fracture. The present case suggested that air density at the anterior portion of the spine on the CT might be an important clue that suggests the existence of rare extensive thoracic spinal fracture.

Keywords

vacuum phenomenon, extensive spinal fracture, computed tomography, diagnosis

Copyright

This work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]	Yanagawa, Y., Ohsaka, H., Jitsuiki, K., Yoshizawa, T., Takeuchi, I., Omori, K., Oode, Y., Ishikawa, K, “Vacuum phenomenon”, Emerg Radiol, 23(4), 377-82, Aug 2016.
[2]	Omori, K,, Ishikawa, K., Obinata, M., Mishima, K., Fukusato, S., Ohsaka, H., Oode, Y., Yanagawa, Y, “Significance of the vacuum phenomenon in patients with trauma evaluated by whole-body computed tomography”, Am J Emerg Med, 33(2), 282-5, Feb 2015.
[3]	Ohsaka, H., Hayashi, C., Omori, K., Yanagawa, Y, “A case of traumatic vacuum phenomenon in the sleeve of a nerve root due to nerve root avulsion”, J Emerg Trauma Shock, 10(4), 216-7, Oct-Dec 2017.
[4]	Obinata, M., Omori, K., Ishikawa, K., Osaka, H., Oode, Y., Yanagawa, Y, “Significance of pneumorrhachis detected by single-pass whole-body computed tomography in patients with trauma”. J Emerg Trauma Shock, 8(2), 120-1, Apr-Jun 2015,
[5]	Matějka, J., Skála-Rosenbaum, J., Krbec, M., Zeman, J., Matějka, T., Zeman, P, “Type AO/ASIF B3 fractures of the thoracic and lumbar spine”, Acta Chir Orthop Traumatol Cech, 80(5), 335-40, 2013. Article in Czech
[6]	Matejka, J, “Hyperextension injuries of the thoracolumbar spine”, Zentralbl Chir, 131(1), 75-9, Feb 2006. in German
[7]	Yamamoto, T., Kobayashi, Y., Ogura, Y., Takahashi, Y., Shinozaki, Y., Ogawa, J, “Delayed leg paraplegia associated with hyperextension injury in patients with diffuse idiopathic skeletal hyperostosis (DISH): case report and review of the literature”, J Surg Case Rep, 2017(3), rjx040, Mar 2017,
[8]	Rustagi, T., Drazin, D., Oner, C., York, J., Schroeder, G.D., Vaccaro, A.R., Oskouian, R.J., Chapman, J.R, “Fractures in Spinal Ankylosing Disorders: A Narrative Review of Disease and Injury Types, Treatment Techniques, and Outcomes”, J Orthop Trauma, 31 Suppl 4, S57-S74, Sep 2017.