A case of dual three-column thoracic spinal fractures following traumatic injury

Abstract

Background: Thoracic spine fracture-dislocations due to motor vehicle accidents (MVAs) rarely involve double- level, noncontiguous lesions. Case Description: A 19-year-old male following an MVA was paraplegic; he exhibited full motor/sensory loss below the T4 level (i.e., ASIA scale Grade A). The chest X-ray, magnetic resonance, and computed tomography studies confirmed T3–T5 and T11–12 fractures, warranting T3–L3 thoracolumbar decompression and fusion. Despite surgical intervention, the patient’s neurological status remained unchanged. Conclusion: This case illustrates the rare presentation of noncontiguous, posttraumatic thoracic spinal lesions requiring simultaneous decompression/fixation.

Double-level noncontiguous thoracic Chance fractures treated with percutaneous stabilization: illustrative case

“…7 Double-level three-column injuries have been reported more recently in the literature with a primary focus on fracture dislocations. [8][9][10][11][12] Few reports have been released in the literature focusing on purely double-level Chance fracture. 13,14 The typical mechanism of injury for Chance fractures is attributed to an MVA, where the individual experiences rapid deceleration while wearing a lap seat belt.…”

“…14,19,20 Our case complements the recent reports recommending more extensive fixation for severe multilevel spinal injuries, based on the outcomes experienced by our patient. 8,9…”

Systematic Review of Traumatic Thoracic Spondyloptosis and Presentation of a Novel Approach for Management With Quad Rod Construct

“…1,2 It is a rare but devastating spinal injury secondary to highenergy trauma. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] Patients with TTS are at increased risk for significant vascular injury, hemodynamic instability, and spinal cord injury. [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Adequate reduction and stabilization allow for early mobilization and rehabilitation.…”

Commentary: Systematic Review of Traumatic Thoracic Spondyloptosis and Presentation ofNovel Approach for Management WithQuad Rod Construct

“…1 It is a rare but devastating form of spinal injury typically due to high-energy trauma such as motor vehicle crush, or less commonly from lower-energy trauma such as a fall in patients with severe osteoporosis. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] Patients with TTS are at a greater risk for vascular injury, hemodynamic instability, and spinal cord injury. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] However, sufficient reduction and stabilization can facilitate early mobilization and rehabilitation.…”

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] However, sufficient reduction and stabilization can facilitate early mobilization and rehabilitation. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17] The authors of the current study 19 performed a systematic review of surgical management of TTS patients from 1983 to 2021 using Preferred Reporting Items for Systematic Reviews and Meta-Analyses for Individual Patient Data (PRISMA-IPD) guidelines with 2 independent reviewers. 20 The authors identified 17 articles with a total of 38 patients with TTS managed surgically.…”