Complete Fracture-Dislocation of the Lower Lumbar Spine With Spontaneous Neurologic Decompression

Abdel-Fattah, Hussein M.; Rizk, Ahmad H.

doi:10.1097/00003086-199002000-00022

Cited by 24 publications

(26 citation statements)

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“…5 Treatment of such cases is rarely described. 4,9,10 The fracture-dislocation of thoracolumbar spine has been classified based on different mechanisms. 6,7 In this study, most patients (8/11) had complete neurological deficit, and they did not recover after surgery; 2 patients had incomplete paraplegia, and they improved 1 ASIA grade after surgery.…”

Section: Discussionmentioning

confidence: 99%

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Treatment of Complete Fracture-dislocation of Thoracolumbar Spine

Wang

Zhu

2013

Journal of Spinal Disorders &Amp; Techniques

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Although difficult, satisfactory reduction of complete lumbar fracture-dislocation can be achieved through pedicle instrumentation. Intraoperative traction is necessary for the reduction procedure. Preoperative duration should be not >3 weeks. For the patient who cannot receive spine surgery in a few days after injury, preoperative traction should be applied. Covering dura sac by autologous fat graft is recommended for all the patients.

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Section: Discussionmentioning

confidence: 99%

“…8,10,13 Conservative treatment has only been recommended in older patients or those with severe underlying disease or complication. 8,10,13 Conservative treatment has only been recommended in older patients or those with severe underlying disease or complication.…”

Section: Discussionmentioning

confidence: 99%

Treatment of Complete Fracture-dislocation of Thoracolumbar Spine

Wang

Zhu

2013

Journal of Spinal Disorders &Amp; Techniques

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“…At the level of L5, the spinal canal is wide and the nerve roots are more resistant to compressive forces than is the conus medullaris at the thoracolumbar junction. 1,7) For this reason, neurologic deficits are less common in L5 fractures than in fractures involving the thoracolumbar area, and recommendations for treatment are controversial. 9) Conservative management was proposed in patients with isolated burst fractures of the L5 vertebra without neurological damage and satisfactory clinical outcome with very good pain status was reported.…”

Section: Discussionmentioning

confidence: 99%

Single Stage Posterior Lumbar-Sacral Reconstruction with Expendable Cage and Iliac Screw for Fifth Lumbar Fracture-Dislocation

Choi

Cho

Lee

et al. 2013

Korean J Neurotrauma

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Fracture-dislocations of the fifth lumbar vertebra are rare. Treatment of L5 vertebra fractures depends on fracture type and neurological findings. The authors describe a single-staged surgical technique of only posterior circumferential decompression, spinal reconstruction with expandable cage insertion and instrument fixation. (Korean J Neurotrauma 2013;9:135-138) KEY WORDS: Burst fracture ㆍExpandable cage ㆍFracture-dislocation ㆍFifth lumbar vertebra.

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“…Only five cases are reported in the English literature,6 two of which were retrolisthesis 78 We report one case of L4–L5 traumatic posterior dislocation of L4 vertebral body caused by high-energy trauma.…”

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confidence: 87%

Traumatic Posterior L4–L5 Fracture Dislocation of the Lumbar Spine: A Case Report

Zárate-Kalfópulos

Romero-Vargas

Alcántara-Canseco

et al. 2012

Global Spine Journal

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Study Design Case report. Objective The diagnosis and surgical management of a patient with traumatic bilateral posterior dislocation of L4–L5 is presented with a thorough review of the existing literature. Summary of Background Data Traumatic dislocation of L4–L5 has been reported in the English literature in only five cases; of these, only two were retrolisthesis. Methods A 20-year-old patient was involved in a high-energy vehicular accident and presented with back pain and inability to ambulate. Neurological assessment showed motor strength grade 2/5 in the proximal lower-extremity muscle groups (L1–L3 myotomes) and 0/5 strength distally (L4–S1 myotomes); in addition, incontinence of sphincters was found. X-rays and computed tomography (CT) scan revealed a three-column ligamentous injury with posterior fracture-dislocation of the L4 vertebral body with complete posterior displacement of L4 to L5 vertebral body. The patient underwent posterior approach with reduction, transpedicular fixation, and posterolateral fusion with autologous bone graft. Results At 1-year follow-up, the patient had recovered muscular strength in proximal lower-extremities muscle groups, sphincter function had fully recovered, and he was able to ambulate with crutches. There was no recovery of distal extremity sensorimotor function. Plain radiograph and CT scan showed good alignment and progressive maturation of his fusion procedure. Conclusion Traumatic retrolisthesis of L4–L5 is a high-energy unstable fracture; reduction of the dislocation is challenging because of the heavy forces acting in the lower lumbar spine. Instrumented fusion restores alignment and maintains segmental stability.

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Complete Fracture-Dislocation of the Lower Lumbar Spine With Spontaneous Neurologic Decompression

Cited by 24 publications

References 0 publications

Treatment of Complete Fracture-dislocation of Thoracolumbar Spine

Treatment of Complete Fracture-dislocation of Thoracolumbar Spine

Single Stage Posterior Lumbar-Sacral Reconstruction with Expendable Cage and Iliac Screw for Fifth Lumbar Fracture-Dislocation

Traumatic Posterior L4–L5 Fracture Dislocation of the Lumbar Spine: A Case Report

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