Lap-belt injury with complete avulsion of the spinal cord and cauda equina.
The authors report a child who was involved in an automobile accident. The patient was restrained by a rear seat lap belt. Radiological examination revealed an L4 Chance-type fracture and ligamentous disruption at the L4-L5 interval. During superficial dissection of the paraspinal muscles for a spinal fusion procedure, the cauda equina and the lower spinal cord (several centimeters) were visible, completely transected and herniated into the extraspinal space through a disrupted thoracolumbar fascia. The clinician should be aware of the potentially devastating results following a lap-belt injury in which a Chance fracture is produced.
Tubbs
R Shane
RS
Department of Cell Biology, University of Alabama at Birmingham, Birmingham, Alabama 35233, USA. rstubbs@uab.edu
Golden
Blake
B
Doyle
Scott
S
Grabb
Paul A
PA
Oakes
W Jerry
WJ
D000063:Accidents, Traffic; D000293:Adolescent; D002420:Cauda Equina / Q000293:injuries* / Q000473:pathology; D006801:Humans; D008159:Lumbar Vertebrae / Q000293:injuries* / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012622:Seat Belts / Q000009:adverse effects*; D013119:Spinal Cord Injuries / Q000473:pathology*; D016103:Spinal Fractures / Q000473:pathology*