Fracture of the posterior margin of the lumbar spine: case report after an acute, unique, and severe trauma.
METHODS
Case report.


OBJECTIVE
We report a case of a posterior margin fracture in the lumbar spine after an acute, unique, and severe trauma with neurologic deficiency in a nonathlete adolescent with no history of lumbar pain. A literature review did not uncover a similar case.


BACKGROUND
Fracture of the posterior margin of lumbar vertebral body is not a common injury. It usually occurs in adolescent and young adults and has been always reported after sports-related microtraumatisms. Symptoms are mainly back pain and radicular pain. Neurologic deficiency is rare.


CONCLUSIONS
An acute and severe spine trauma in a nonathlete adolescent with no previous history of lumbar pain can lead to posterior vertebra margin fracture. Neurologic deficiency may appear, and it can be directly related to the posterior displacement of bone fragment or to a compressive peridural hematoma. Radiographs and computed tomograph scans are used for diagnosis. Magnetic resonance imaging is accurate to visualize disc space and for the diagnosis of peridural hematoma. Treatment is surgical and consists of laminectomy, hematoma drainage, and excision of bone fragment. Discectomy and arthrodesis are to be considered in relation to age, magnetic resonance imaging findings, and type of bone lesions.
Molina
Véronique
V
Department of Orthopaedic and Traumatologic Surgery, University Hospital of Bicêtre, France. veromolina@wanadoo.fr
Court
Charles
C
Dagher
Georges
G
Pourjamasb
Bahman
B
Nordin
Jacques-Yves
JY
D000293:Adolescent; D046748:Hematoma, Epidural, Spinal / Q000209:etiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology / Q000473:pathology; D009408:Nerve Compression Syndromes / Q000209:etiology / Q000473:pathology / Q000601:surgery; D016103:Spinal Fractures / Q000150:complications / Q000473:pathology* / Q000601:surgery; D013406:Suicide, Attempted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014947:Wounds and Injuries