Case report: L4-5 posterior subluxation combined with L4 compression fracture
Authors:
Jiří Šrámek 1,2; Rudolf Bertagnoli 1
Authors‘ workplace:
Klinika ProSpine, Bogen, BRD
ProSpine Clinic, Bogen, Germany
1; Fakulta biomedicínského inženýrství, České vysoké učení technické v Praze, ČR
Faculty of Biomedical Engineering, Czech Technical University in Prague, Czech Republic
2
Published in:
Úraz chir. 24., 2016, č.1
Overview
PURPOSE:
The purpose of the study was to introduce a diagnostic and surgical procedure for treatment of posterior subluxation of lumbar spine.
MATERIAL AND METHODS:
The authors describe a diag-nostic decision and surgical approach in a case of 42 years old female patient, who suffered L4 compression fracture combined with L4-5 posterior subluxation in a car accident. The injury was not initially diagnosed. The case was re-evaluated by spine surgeon due to progressive neurological impairment. A posterior subluxation with severe spinal canal stenosis caused by injured soft tissue elements and epidural hematoma together with complete posterior column disruption was found on MRI. A decompression, pedicle instrumentation and XLIF L3-4-5 was perfomed.
RESULTS:
At one year follow up the patient is without lumbar pain, without any restrictions on activities of daily living, without painkillers use. X-ray examination shows correct position of implants, without reduction loosening.
CONCLUSION:
The described surgical procedure is commonly used for severe thoracolumbar spine injuries. It is crucial not to overlook mild subluxations on CT scan, because MRI examination in such cases can manifest much worse damage.
Key words:
thoracolumbar spine, posterior subluxation, dislocation.
Sources
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3. MAGERL, F., AEBI, M., GERTZBEIN, S. et al. A comprehensive classification of thoracic and lumbar injuries. European Spine Journal. 1994, 3, 184–201. ISSN 0940-6719
4. MATĚJKA, J., SKÁLA-ROSENBAUM, J., KRBEC, M. et al. Poranění hrudní a bederní páteře typu B3 dle AO-ASIF. Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca. 2012, 80, 335–340. ISSN 0001-5415
5. ŠEBESTA, P., ŠTULÍK, J., VYSKOČIL, T. et al. Jednostranná luxace hrudní a bederní páteře. Acta chirurgiae orthopaedicae et traumatologiae Ce-choslovaca. 2005, 72, 317–321. ISSN 0001-5415
6. VACCARO, A., ONER, C., KEPLER, C. et al. AOSpine thoracolumbar spine injury classification system: fracture description, neurological status, and key modifiers. Spine. 2013, 38, 2028–2037. ISSN 0362-2438
7. ZARATE-KALFOPULOS, B., ROMERO-VARGAS, S., ALCÁNTARA-CANSECO, C. et al. Traumatic posterior L4-L5 fracture dislocation of the lumbar spine: a case report. Global Spine Journal. 2012, 2, 235–238. ISSN 0032-1329
8. ZHOU, T., TANG, X., XU, Y. et al. Traumatic spondyloptosis of L4. Spine. 2010, 35, E855–E859. ISSN 0362-2438
Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2016 Issue 1
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