Adjacent fracture-dislocations of the lumbosacral spine: case report.
OBJECTIVE
Traumatic fracture-dislocations of the lumbosacral junction are rare, with all previously reported cases involving fracture-dislocations at a single level. No cases of multiple fracture-dislocations of contiguous spinal segments in the lumbosacral spine have been reported. A case of traumatic adjacent fracture-dislocations of the fifth lumbar segment is presented.


METHODS
An 18-year-old male patient sustained open lumbar spinal trauma after a motor vehicle accident. A neurological examination revealed an L4 level. Radiographic evaluation of the spine revealed a three-column injury at L5 with spondyloptosis of the L5 vertebral body. Aorto-ilio-femoral angiography revealed no evidence of vascular injury.


METHODS
The patient was treated with a combined anterior and posterior approach in a two-stage operation. Six months postoperatively, he was neurologically unchanged; however, he was able to walk with the aid of a cane. Plain films revealed normal alignment of the lumbosacral spine.


CONCLUSIONS
The management of traumatic lumbosacral fracture-dislocations requires careful consideration of retroperitoneal structures and possible exploration of the iliac vessels in addition to spinal reconstruction.
Kaplan
S S
SS
Department of Neurological Surgery, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Wright
N M
NM
Yundt
K D
KD
Lauryssen
C
C
D000293:Adolescent; D000792:Angiography; D006801:Humans; D004204:Joint Dislocations / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000098:blood supply / Q000000981:diagnostic imaging; D008161:Lumbosacral Region; D008297:Male; D009984:Orthopedic Fixation Devices; D013116:Spinal Cord / Q000503:physiopathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D013123:Spinal Fusion; D014057:Tomography, X-Ray Computed