Traumatic noncontiguous double fracture-dislocation of the lumbosacral spine

Samuel K. Cho, Lawrence G. Lenke, Darrell Hanson

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Background context: To our knowledge, the presence of noncontiguous fracture-dislocation of the lumbosacral spine occurring at two levels has not been reported. The etiology, evaluation, and treatment of the unusual injury is presented. Purpose: To notify spinal traumatologists about the possibility of this unusual injury. Study design: A case report of an unusual noncontiguous double fracture-dislocation of the lumbosacral spine. Methods: A 26-year-old man was involved in a motor vehicle accident where his car fell over a bridge and plummeted approximately 300 feet before hitting the ground. The patient was transported to a major medical center where he was found to be conscious, and amazingly, his only major injury was fracture-dislocations of L2-L3 and L5-S1. His preoperative neurologic status showed a partial paraparesis to all motor groups of the lower extremities bilaterally. Results: The patient underwent a posterior reduction, instrumentation, and fusion from L1 to S1 with autogenous bone graft and segmental pedicle screw instrumentation. One week postoperatively, he underwent an anterior spinal fusion of L5/S1. Postoperatively, his neurologic status improved allowing him to be ambulatory, with a normal lumbosacral alignment being well-maintained. Conclusions: Noncontiguous double fracture-dislocation of the lumbosacral spine is an unusual injury, which results from a very high-energy trauma. Prompt recognition of the injuries, reduction of the fracture-dislocations, and posterior stabilization is recommended for neural decompression, spinal alignment, and long-term stabilization.

Original languageEnglish
Pages (from-to)534-538
Number of pages5
JournalSpine Journal
Volume6
Issue number5
DOIs
StatePublished - Sep 2006
Externally publishedYes

Keywords

  • Anterior spinal fusion
  • Lumbar fracture-dislocation
  • Lumbosacral fracture-dislocation
  • Noncontiguous fracture-dislocations
  • Posterior instrumentation and fusion

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