Fracture-Dislocation of the Thoracic Spine without Any Neurological Deficit: A Case Report and Review of the Literature

Nabizadeh , Naveed; Gomrokchi, Alireza Yousof; Lirgeshasi, Sam Bemani; Bahari, , Milad

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Volume 7, Issue 3 (9-2018)

Int J Med Invest 2018, 7(3): 64-72

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Fracture-Dislocation of the Thoracic Spine without Any Neurological Deficit: A Case Report and Review of the Literature

Naveed Nabizadeh

, Alireza Yousof Gomrokchi ^*

, Sam Bemani Lirgeshasi

, , Milad Bahari

Bone and Joint Reconstruction Research Center , Shafa Orthopedic Hospital ,Iran University of Medical Sciences ,Tehran ,IR Iran

Abstract: (6887 Views)

Introduction: Thoracic spinal fracture dislocation injury usually is caused by a high-energy trauma. Therefore, this kind of injury should always be suspected in the patients who have sustained a multiple trauma. The thoracic spinal fracture-dislocation is commonly accompanied by neurological symptoms. In the literature, only few cases are reported who did not present neurological symptoms. Case presentation: A 25-year-old man was brought to our emergency department following a vigorous motor-vehicle accident, complaining from excruciating pain in his right shoulder. The promptly obtained radiographs revealed right shoulder fracture dislocation that was reduced through intervenus sedation, in the emergency department. The overt shoulder injury distracted the ER physician’s attention from the vertebral translation, visualized in the initial chest radiographs. Secondary survey, obtained on the next day, revealed a serious T5-T6 fracture-dislocation and absence of neurological deficit. The computed tomography and magnetic resonance imaging provided the details of the spinal injury. Open reduction and stabilization was performed by application of the rods and pedicle screws. The neurologic condition remained intact postoperatively. A CTLSO brace was administrated to wear whenever he was walking or sitting. The brace was weaned off at the 24th week when he started physical exercises. Conclusions: In a small number of patients who suffered spinal fracture-dislocation, the radiographic feature or severity does not correlate with the clinical manifestation. The treatment strategy is tailored individually, i.e., open reduction and internal fixation is advised whenever surgical intervention is indicated.

Keywords: Dislocation, Fracture, Thoracic vertebrae, Neurological deficit

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Type of Study: case report | Subject: General

References

1. 1. Korovessis P, Sidiropoulos P, Dimas A. Complete fracture-dislocation of the thoracic spine without neurologic deficit: case report. The Journal of trauma. 1994 Jan;36(1):122-4. 2. Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. spine. 1983;8(8):817-31. 3. Bohlman HH. Treatment of fractures and dislocations of the thoracic and lumbar spine. JBJS. 1985 Jan 1;67(1):165-9. 4.Jiang B, Zhu R, Cao Q, Pan H. Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures: a case report and review of the literature. Journal of medical case reports. 2014 Dec;8(1):343. 5.Dorr LD, Harvey JJ, Nickel VL. Clinical review of the early stability of spine injuries. Spine. 1982;7(6):545-50. 6.AKAY KM, BAYSEFER A, KAYALI H, BEDUK A, TIMURKAYNAK E. Fracture and lateral dislocation of the T12-L1 vertebrae without neurological deficit. Neurologia medico-chirurgica. 2003;43(5):267-70. 7. Sasson A, Mozes G. Complete Fracture-Dislocation of the Thoracic Spine Without Neurologic Deficit: A Case Report. Spine. 1987 Jan 1;12(1):67-70. 8.Vialle LR, Vialle E. Thoracic spine fractures. Injury. 2005 Jul;36:B65-72. 9.Holdsworth FW. Fractures, dislocations, and fracture-dislocations of the spine. The Journal of Bone and Joint Surgery. British Volume. 1963 Feb;45(1):6-20. 10. Abdel-Fattah HU, Rizk AH. Complete fracture-dislocation of the lower lumbar spine with spontaneous neurologic decompression. Clinical orthopaedics and related research. 1990 Feb(251):140-3. 11. Miyasaka Y, Satomi K, Sugihara S, Tahara Y, Hayashi T, Ishii Y. Posterior fracture-dislocation of the thoracic spine without neurologic deficit. A case report and short literature review. Spine. 1993 Nov;18(15):2351-4. 12. Bohlman HH, Freehafer A, Dejak J. The results of treatment of acute injuries of the upper thoracic spine with paralysis. The Journal of bone and joint surgery. American volume. 1985 Mar;67(3):360-9. 13. Simpson AH, Williamson DM, Golding SJ, Houghton GR. Thoracic spine translocation without cord injury. Bone & Joint Journal. 1990 Jan 1;72(1):80-3. 14. Fehlings MG, Cadotte DW, Fehlings LN. A series of systematic reviews on the treatment of acute spinal cord injury: a foundation for best medical practice. Journal of neurotrauma. 2011 Aug 1;28(8):1329-33. 15. Wiggins GC, Mirza S, Bellabarba C, West GA, Chapman JR, Shaffrey CI. Perioperative complications with costotransversectomy and anterior approaches to thoracic and thoracolumbar tumors. Neurosurgical focus. 2001 Dec;11(6):1-9. 16. Weber SC, Sutherland GH. An unusual rotational fracture-dislocation of the thoracic spine without neurologic sequelae internally fixed with a combined anterior and posterior approach. The Journal of trauma. 1986 May;26(5):474-9. 17. Gertzbein SD, Offierski C. Complete fracture-dislocation of the thoracic spine without spinal cord injury. A case report. JBJS. 1979 Apr 1;61(3):449-51. 18. Uriarte EN, Elguezabal B, Tovio RA. Fracture-dislocation of the thoracic spine without neurologic lesion. Clinical orthopaedics and related research. 1987 Apr(217):261-5.

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Nabizadeh N, Gomrokchi A Y, Lirgeshasi S B, Bahari , M. Fracture-Dislocation of the Thoracic Spine without Any Neurological Deficit: A Case Report and Review of the Literature. Int J Med Invest 2018; 7 (3) :64-72
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