Seizure-Induced Spinal Fractures: A Systematic Review

Luis A. Robles; Amancio Guerrero-Maldonado

doi:10.14444/8244

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Flow chart of the literature search strategy and article selection for screening and analysis.
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Figure 2
Bar chart showing the frequency of types of thoracolumbar fractures observed in this review. Different fracture patterns were observed in the same patient.

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Summary of patients with seizure-induced spinal fractures.

Author, Year	Age, y (Sex)	Symptoms	Cause of Seizures	Epilepsy Treatment	Number Seizures	Level of Spine	AO Fracture Type	Evolution Time	Dual-Energy X-ray Absorptiometry	Associated Conditions	Treatment	Outcome
Lim & Shim, 202137	50 (M)	LBP Paraparesis	Hepatic cirrhosis	No	Multiple	L2	A4	1 d	Osteoporosis	Encephalopathy	360° T2-L4 stabilization	Partial recovery
Bosco et al, 202036	52 (M)	LBP Paraparesis	Idiopathic First seizure	No	1	L1	Burst A4	4 mo	No		T11-L3 instrumentation	Complete recovery
Robichaud et al, 20205 Case 1 Case 2	71(M) 53 (M)	LBP Paraparesis LBP Paraparesis	Intracranial meningioma Idiopathic	No No	1 1	L1 L1	Burst A4 Burst A4	1 wk NA	No No	Intracranial meningioma Scapular fractures	Laminectomies T11-L3 stabilization Decompression T11-L3 stabilization	Partial recovery Partial recovery
Grzonka et al, 20196	49 (M)	Interscapular pain	Idiopathic	No	Multiple	T4	A1	1 d	No	Scapular fractures	Conservative	Complete recovery
Hurley et al, 20197	47 (F)	Neck pain	Gelastic seizure	Carbamaze pine + lamotrigine	NA	C2	Hangman type II	1 wk	No	NA	Occipitocervical fusion	Complete recovery
Smith et al, 20178	44 (F)	Dorsal pain	Venlafaxine overdose	No	1	T8	Burst A4	1 wk	No	Depression	T7-T11 stabilization	Complete recovery
Stilwell et al, 20169	28 (M)	Dorsal pain	Idiopathic epilepsy	Lamotrigine 1 y	1	T6-T7	A1	10 d	Normal		Conservative analgesics	Complete recovery
Gill et al, 201510	61 (F)	Dorsal pain	NA	No	Multiple	T6	T6 burst A4 L5 A1		No	Sternal fracture, bilateral humerus fractures, femur fracture	T4-T8 stabilization Lumbar conservative	Complete recovery
Moscote-Salazar et al, 201511	46(M)	LBP	NA	NA	NA	L2	A2	2 d	No		Posterior fusion	Complete recovery
Atalar et al, 201512	49 (M)	Dorsal pain	Idiopathic, first seizure	No	1	T5-T8	A1	1 d	Osteoporosis	Type 1 diabetes	Conservative brace	Complete recovery
Ali et al, 201513	52 (M)	LBP	Brain tumor	No	NA	L3	A2		No	Shoulders dislocation	Conservative	NA
Uvaraj et al, 201414	18(M)	Dorsal pain	Idiopathic	No	1	T5-T8	A1	3 d	No	No	Brace, conservative	Complete recovery
Majkowska et al, 201415	21 (F)	LBP	Hypoglycemia	No	1	T12	A4	11 mo	Osteopenia	Type 1 diabetes	Surgery stabilization	NA
Ghayem Hasankhani et al, 201316	42 (M)	LBP	NA	NA	1	L2-3-4	A1	NA	Normal	No	Brace, conservative	Complete recovery
Rahimiza- deh et al, 201217	20 (M)	LBP Hypoesthesia lower limbs	Tramadol overdose	No	1	T12	Burst A4	1 wk	No		T10-L2 stabilization	Complete recovery
Alian, 201118	35 (F)	LBP	Idiopathic epilepsy	No	1	T12	Burst A4	2 d	No		Stabilization T11-L1	NA
Malik et al, 201119	42 (F)	LBP	Hypoglycemia	No	1	L2	Burst A3	5 d	No	Diabetes	Brace, conservative	Complete recovery
Sharma et al, 201120	36 (M)	LBP Cauda equina syndrome	Idiopathic epilepsy	Phenytoin	1	L1 L2	Burst A4 A1	1 d	No	Humeral fracture	Surgery (no specified)	Partial recovery
Napier and Nolan, 201121	28 (M)	LBP Paraplegia	Idiopathic epilepsy	NA	Multiple	L1	Burst A4	1 d	No		Stabilization T12-L2 Laminectomy	Partial recovery
Is et al, 200922	62 (F)	LBP	Idiopathic	No	1	L1	Burst A4	3 wk	No	Rheumatoid arthritis	L1 corpectomy Stabilization	Complete recovery
Kalaci et al, 200823	11 (M)	Dorsal pain	Isoniazid intoxication	No	Multiple	T5	Burst A3	1 d	Normal		Conservative brace	Complete recovery
Mehlhorn et al, 200724	45 (M)	LBP	Idiopathic epilepsy	No	1	L2 L4	A2 A4	1 d	Osteopenia		L1-L5 stabilization	NA
Shin et al, 200725 Case 1 Case 2	29 (M)34 (F)	LBP Paraparesis LBP	Brain tumor Brain tumor	No No	11	L2-L3 L2	Burst A3 Burst A3	1 d1 d	Osteoporosis Osteopenia	Shoulder dislocation	Anterior L2-4 stabilization Conservative	Complete recovery Complete recovery
Roohi and Fox, 200626	35 (M)	Cauda equina syndrome	Unknown cause	No	1	L1	Burst A3	2 d	No		L1-3 stabilization	Complete recovery
Perry and Atkinson, 200627	42 (M)	Dorsal pain	Unknown	No	1	T6-7-8	A1	NA	No	Dislocation shoulders	Conservative	NA
Gnanalin- gham et al, 200428	26(M)	Dorsal pain	First seizure	No	1	T5-6	A1	1 d	No	History of lupus Steroids use	Kyphoplasty	Complete recovery
Takahashi et al, 200229	34 (M)	Dorsal pain	Idiophatic epilepsy	Multiple drugs	1	T6-7	T6 A1 T7 A4	2 wk	Normal		Corpectomy stabilization T5-8	Complete recovery
Torreggiani et al, 200130	75 (MF	Neck pain	Idiopathic epilepsy	NA	1	C2 dens fracture	Type 2 odontoid fracture C1 fracture	1 d	No		Anterior C2 screw	Partial recovery
Kumar and Freeman, 199931 Case 1 Case 2	44 (M)34 (M)	Neck pain Quadriplegia Neck pain Quadriparesis	Idiopathic epilepsy Idiopathic epilepsy	Phenytoin valproate Phenytoin	NA Multiple	C3-4 C3	C3-4 listesis C3 Canal narrowing	1 d 1 d	No No		360 Stabilization Laminectomy	Partial recovery Partial recovery
Aboukasm and Smith, 199732 Case 1 Case 2	21 (M) 36 (M)	Dorsal pain Dorsal pain	Idiopathic epilepsy Idiopathic epilepsy	No No	11	T7-8-9 T5-6	A1 A1	1 wk 1 d	No No		Conservative Conservative	NA NA
Youssef et al, 199533	35 (M)	LBP	Clozapine use	No	1	L1-L2	L1 A4 L2 A1	5 d	No	schizophrenia	Surgery Stabilization	Complete recovery
McCullen and Brown, 19941	41 (F)	Dorsal pain	Amoxapine intoxication	No	1	T6-T8	T7 A4	1 wk	No	Humeral fracture	Anterior corpectomy T7 stabilization T4-10 posterior	Complete recovery
Gräbe, 198834	39 (M)	LBP	NA	No	1	L5-S1	Lumbosacral dislocation	NA	No		Anterior lumbosacral fusion	Complete recovery
Nabarro, 198535	48 (M)	Dorsal pain	Hypoglycemia	No	1	T3-T4	A1	1 d	No		Conservative	NA