Case report: L4-5 posterior subluxation combined with L4 compression fracture

Czech version

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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Labels

Surgery Traumatology Trauma surgery

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Article was published in

Trauma Surgery

2016 Issue 1