{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:47:30Z","timestamp":1787755650533,"version":"build-2784847793"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JBJS Case Connector"],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>We present the strategies we used in surgical management of delayed presentation of traumatic lumbar fractures with neurological deficits in 2 young primigravida mothers in early trimesters of pregnancy. Posterior stabilization was achieved in a prone position using magnetic resonance imaging (MRI) without radiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Management of spinal cord injury in pregnancy is a delicate scenario in which risks and benefits of surgery have to be explained to the patient for whom surgical management is contemplated. Risk of radiation to the fetus is completely avoided by using MRI perioperatively to assess injury and outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.19.00294","type":"journal-article","created":{"date-parts":[[2019,11,17]],"date-time":"2019-11-17T18:45:39Z","timestamp":1574016339000},"page":"e0294-e0294","source":"Crossref","is-referenced-by-count":2,"title":["Radiation-Free Management of Lumbar Spine Burst Fractures in Pregnant Women"],"prefix":"10.2106","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9586-5028","authenticated-orcid":false,"given":"Uvaraj","family":"R. Nalli","sequence":"first","affiliation":[{"name":"Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5245-4088","authenticated-orcid":false,"given":"Singaravadivelu","family":"Vaithiyanadhan","sequence":"additional","affiliation":[{"name":"Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3673-6936","authenticated-orcid":false,"given":"Hemantha Kumar","family":"Govindarajan","sequence":"additional","affiliation":[{"name":"Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7143-4354","authenticated-orcid":false,"given":"Sathish","family":"Muthu","sequence":"additional","affiliation":[{"name":"Institute of Orthopaedics and Traumatology, Rajiv Gandhi Government General Hospital, Chennai, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2019]]},"reference":[{"key":"bib1-20230811","doi-asserted-by":"crossref","first-page":"1747","DOI":"10.2106\/JBJS.H.01044","article-title":"Management of a pregnant patient with a burst fracture causing neurologic injury","volume":"91","author":"Lenarz","year":"2009","journal-title":"J Bone Joint Surg Am."},{"key":"bib2-20230811","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jbspin.2003.05.003","article-title":"Pregnancy-associated osteoporosis with vertebral fractures and scoliosis","volume":"71","author":"Sarikaya","year":"2004","journal-title":"Joint Bone Spine."},{"key":"bib3-20230811","doi-asserted-by":"crossref","first-page":"258","DOI":"10.4103\/sni.sni_380_18","article-title":"Medical and surgical management of acute spinal injury during pregnancy: a case series in a third-world country","volume":"9","author":"Zemmar","year":"2018","journal-title":"Surg Neurol Int."},{"key":"bib4-20230811","doi-asserted-by":"crossref","first-page":"E614","DOI":"10.1097\/BRS.0b013e31817c6c7d","article-title":"Clinical approach and surgical strategy for spinal diseases in pregnant women: a report of ten cases","volume":"33","author":"Han","year":"2008","journal-title":"Spine (Phila Pa 1976)."},{"key":"bib5-20230811","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1007\/s005860050229","article-title":"Thoracolumbar distraction fractures in advanced pregnancy: a contribution of two case reports","volume":"9","author":"Tanchev","year":"2000","journal-title":"Eur Spine J."},{"key":"bib6-20230811","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1097\/00007632-199105000-00025","article-title":"Spinal cord injury and pregnancy","volume":"16","author":"Paonessa","year":"1991","journal-title":"Spine."},{"key":"bib7-20230811","first-page":"213","article-title":"Pregnancy damage and birth complications in the children of paraplegic women","volume":"10","author":"Goller","year":"1972","journal-title":"Paraplegia."},{"key":"bib8-20230811","doi-asserted-by":"crossref","first-page":"556","DOI":"10.1097\/00006254-199507000-00022","article-title":"Acute spinal cord injury and neurogenic shock in pregnancy","volume":"50","author":"Gilson","year":"1995","journal-title":"Obstet Gynecol Surv."},{"issue":"20","key":"bib9-20230811","doi-asserted-by":"crossref","first-page":"1597","DOI":"10.1001\/jama.1997.03540440031029","article-title":"Administration of methylprednisolone for 24 or 48 hours or tirilazad mesylate for 48 hours in the treatment of acute spinal cord injury. Results of the Third National Acute Spinal Cord Injury Randomized Controlled Trial. National Acute Spinal Cord Injury Study","volume":"277","author":"Bracken","year":"1997","journal-title":"JAMA."},{"issue":"24","key":"bib10-20230811","doi-asserted-by":"crossref","first-page":"1958","DOI":"10.1089\/neu.2014.3778","article-title":"Mean arterial blood pressure correlates with neurological recovery after human spinal cord injury: analysis of high frequency physiologic data","volume":"32","author":"Hawryluk","year":"2015","journal-title":"J Neurotrauma."},{"issue":"3","key":"bib11-20230811","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1097\/01.aco.0000192816.22989.ba","article-title":"Vasopressors in obstetrics: what should we be using?","volume":"19","author":"Ngan Kee","year":"2006","journal-title":"Curr Opin Anaesthesiol."},{"issue":"2","key":"bib12-20230811","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1302\/0301-620X.49B2.327","article-title":"An operation frame for spinal fusion. A new apparatus designed to reduce haemorrhage during operation","volume":"49","author":"Relton","year":"1967","journal-title":"J Bone Jt Surg Br."},{"key":"bib13-20230811","article-title":"Pregnancy and radiation exposure","author":"Brent","year":"2008","journal-title":"Health Phys Soc."},{"issue":"4","key":"bib14-20230811","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1148\/rg.274065149","article-title":"Radiation exposure and pregnancy: when should we be concerned?","volume":"27","author":"McCollough","year":"2007","journal-title":"Radiographics."},{"issue":"3","key":"bib15-20230811","first-page":"323","article-title":"Ionizing radiations in pregnancy and teratogenesis: a review of literature","volume":"20","author":"De Santis","year":"2005","journal-title":"ReprodToxicol."},{"issue":"2-3","key":"bib16-20230811","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.pbiomolbio.2004.08.010","article-title":"A review of the current use of magnetic resonance imaging in pregnancy and safety implications for the fetus","volume":"87","author":"De Wilde","year":"2005","journal-title":"Prog Biophys Mol Biol."},{"key":"bib17-20230811","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1080\/01443610310001604321","article-title":"Acute spinal cord injury in pregnancy: an illustrative case and literature review","volume":"23","author":"Popov","year":"2003","journal-title":"J Obstet Gynaecol."},{"key":"bib18-20230811","doi-asserted-by":"crossref","first-page":"17052","DOI":"10.1038\/scsandc.2017.52","article-title":"Spinal cord injury during the second trimester of pregnancy","volume":"3","author":"Qureshi","year":"2017","journal-title":"Spinal Cord Ser Cases."},{"issue":"9","key":"bib19-20230811","doi-asserted-by":"crossref","first-page":"1116","DOI":"10.1111\/j.1471-0528.2000.tb11110.x","article-title":"Antenatal use of enoxaparin for prevention and treatment of thromboembolism in pregnancy","volume":"107","author":"Ellison","year":"2000","journal-title":"BJOG."},{"issue":"1","key":"bib20-20230811","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1007\/s11239-015-1309-0","article-title":"Guidance for the treatment and prevention of obstetric-associated venous thromboembolism","volume":"41","author":"Bates","year":"2016","journal-title":"J Thromb Thrombolysis."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:45:41Z","timestamp":1787751941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.19.00294"}},"subtitle":["A Report of Two Cases"],"short-title":[],"issued":{"date-parts":[[2019]]},"references-count":20,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2019]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.19.00294","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019]]}}}