title: Complete Fracture-Dislocation of the Thoracolumbar Spine with No Critical Neurological Deficit: A Case Report.
abstract: Fractures at the thoracolumbar junction are the most common spinal column fractures. Among type C fractures in the Arbeitsgemeinschaft für Osteosynthesefragen Spine Classification, cases with complete fracture-dislocations of the spinal column often result in a critical neurological deficit despite surgical treatment. We present a case of an 18-year-old man who had a complete fracture-dislocation of the T12 vertebral body and multiple injuries following high-energy trauma but no critical neurological deficits. Because of active bleeding in the left thoracic cavity, the patient underwent open reduction of the T12 vertebral body and anterior spinal fusion of the T11-L1 vertebral bodies via an anterior approach between the T9 and T10 ribs within 24 h of the accident. Four months postoperatively, the patient could ambulate independently, with a slight disturbance of light touch. At 6 months postoperatively, plain computed tomography scans showed bony union of the T12 vertebral body. We postulated two reasons for the absence of critical neurological dysfunction: (1) spontaneous spinal canal sparing because of the fracture of the right superior articular process in the L1 vertebral body and (2) fracture morphology, that is, a rotational fracture with mild to moderately strong shearing stress to the dura mater.
authors.affiliation: Department of Orthopedics, Mitoyo General Hospital.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Sugiura
authors.forename: Toshinori
authors.initials: T
authors.lastname: Sakai
authors.forename: Keisuke
authors.initials: K
authors.lastname: Adachi
authors.forename: Kazumasa
authors.initials: K
authors.lastname: Inoue
authors.forename: Satoshi
authors.initials: S
authors.lastname: Endo
authors.forename: Yasuaki
authors.initials: Y
authors.lastname: Tamaki
authors.forename: Koichi
authors.initials: K
authors.lastname: Sairyo
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nagamachi
mesh_terms: D000293:Adolescent; D000072039:Fracture Dislocation / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D021621:Imaging, Three-Dimensional; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D008279:Magnetic Resonance Imaging; D008297:Male; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D013904:Thoracic Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries*; D014057:Tomography, X-Ray Computed