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CT scan images of thoracolumbar spine demonstrating spinal fracture. (A) Sagittal CT scan showing T12 fracture with comminuted vertebral body. (B) Axial CT scan at T12 level demonstrating violation of the posterior cortex of vertebral body with retropulsion of bone fragments.
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Achilles tendon. A complete trauma assessment was performed and CT scan of the lumbar spine revealed a severely comminuted T12 burst fracture with retropulsion of bone fragments into the spinal canal (see Figure 1).
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Graphical representation of the surgical site. The fiberoptic wire is seen placed through the dura into the subdural space at the site of injury. A fat graft was placed at the site of insertion to prevent pseudomeningocele formation.
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A locally harvested fat graft was then placed over the site where the catheter was entering the dural opening (see Figure 2).
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(A) Shows a two-dimensional contour plot of the patient's entire recording period displaying the time spent at various mean arterial pressures (MAP) and intraspinal pressures (ISP). The lighter the shade of blue the greater proportion of time spent at the corresponding MAP and ISP. Notably, there is a peninsula in with lower ISP values attributable to the immediately postoperative period with ISP values ranging from approximately 15-25 mmHg. (B) Shows a contour plot examining the relationships between ISP, MAP, and spinal cord pressure reactivity index (ScPRx). ScPRx ranges in color from red (most disrupted) to green (most intact). There seems to be a trend with low concurrent ISP and MAP being associated with intact ScPRx while high ISP and MAP is associated with disrupted ScPRx.
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Figure 3 displays data density (Panel A) and contour plots for MAP, ISP and ScPRx.
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(A) Demonstrated the mean arterial pressure (MAP, red line) and intraspinal pressure (ISP, purple line) waveforms as they are recorded in real-time. (B) Displays the processed minute-to-minute physiologic data. This includes directly measured parameters such as MAP (red line) and ISP (purple line) as well as derived parameters, spinal cord pressure reactivity index (ScPRx, black line), spinal cord perfusion pressure (ScPP, brown line), and optimal spinal cord perfusion pressure (ScPPopt, green line).
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In Figure 4, Panel A displays examples of the continuous full waveform (100 Hz) time trends of both ABP and ISP.
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