Traumatic L4–L5 spondylolisthesis: case report

Deniz, Fatih Ersay; Zılelı, Mehmet; Çağlı, Sedat; H, Kanyilmaz

doi:10.1007/s00586-007-0496-6

Cited by 38 publications

(40 citation statements)

References 6 publications

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“…1,8 Although "en bloc" lumbar segmental fracture, 3,16,17 lateral lumbosacral dislocations, 11 and double-level fracture-dislocations lumbosacral spine 12 have been reported, there are no cases in which lateral lumbar dislocations at more than 1 junction have been described. To our knowledge, this is the first case report of the presence of lateral lumbar dislocations in 2 noncontiguous lesions.…”

Section: Discussionmentioning

confidence: 99%

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Two-level traumatic lateral lumbar fracture and dislocation in a heavy equipment operator: a case report

Nakao¹,

Kajino

2013

Journal of Chiropractic Medicine

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Objective: Lumbar fracture-dislocations are rare and invariably due to high-energy trauma. The purpose of this study is to report the surgical management of a man with lateral lumbar dislocations in 2 noncontiguous lesions. Clinical features: A 49-year-old Asian man was crushed by a bulldozer. The patient was transported to a major medical center where he was found to be conscious, and the primary spinal injuries were fracture-dislocation of L1-L2 and L4-L5. His preoperative neurologic status showed a partial paraparesis to all motor groups of the lower extremities bilaterally. His radiological and operative findings showed a rupture of the thoracolumbar fascia and latissimus dorsi muscle, left L1-L2 dislocated facet, right L4-5 facet fracture, and dural tear. Intervention and outcome: The patient underwent a posterior reduction, decompression, instrumentation, and fusion surgery from T12 to S1 with autologous bone graft and pedicle screw instrumentation. Postoperatively, his neurologic status improved, allowing him to be ambulatory using a Lofstrand crutch with improved lumbosacral alignment being well maintained. Two weeks postoperatively, the patient regained voluntary bowel and bladder function. At the 1-year follow-up evaluation, his motor power was full in the left leg; however, sensation to pin prick remained lost on the right L5 and S1 distributions. He continued to ambulate using a Lofstrand crutch. Conclusion: Lateral lumbar fracture-dislocation at 2 noncontiguous levels is an unusual injury that results from high-energy trauma. Prompt recognition of the injuries, reduction of the fracture-dislocations, and posterior stabilization are recommended for neural decompression, spinal alignment, and long-term stabilization.

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Section: Discussionmentioning

confidence: 99%

“…3 Watson-Jones 4 described the first traumatic spondylolisthesis case in 1940 and about a hundred cases have been reported since then. [5][6][7][8][9][10][11][12] But most of the reported cases are traumatic dislocations at the L5-S1 level. These injuries usually occur at a single level.…”

Section: Introductionmentioning

confidence: 99%

Two-level traumatic lateral lumbar fracture and dislocation in a heavy equipment operator: a case report

Nakao¹,

Kajino

2013

Journal of Chiropractic Medicine

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“…Our case also suffered from fractures of transverse processes, which support the above viewpoint. However, the transverse process fracture is not the necessary sign associated with this kind of injury 7 , 8…”

Section: Discussionmentioning

confidence: 99%

“…Some authors supported that hyperextension stress7, hyperflexion and compression stress9, or tangential force9 may be responsible for the occurrence of the trauma. It is challenging to propose an exact mechanism when the injury is complicated and severe.…”

Section: Discussionmentioning

confidence: 99%

Traumatic lumbar spondylolisthesis

Tang¹

2012

Pak J Med Sci

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Traumatic lumbar spondylolisthesis is a rare lesion and frequently noted in patients with multiple traumatic injuries. We report one case of L5 traumatic spondylolisthesis, which obtained successful decompression, reduction, interbody fusion and fixation by posterior lumbar interbody fusion, and got satisfactory outcome. We recommend early decompression, reduction, interbody fusion and fixation with posterior instrumentation to obtain the recovery of neurological function and stability of the spine.

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“…[1][2][3][4] Although there is one case in the literature that reports spontaneous reduction of a fracture-dislocation when carrying out imaging studies, 5 there are few cases reported in the worldwide literature on recovery of neurological function after surgery, with adequate reduction of dislocations of distal segments of the lumbar region. 2,3,[6][7][8][9] Antony J. Herrera et al in Belgium, in their report of a case called single-level transforaminal fusion, concluded that in traumatic fracture dislocation, intersomatic fusion is considered an option. 6 …”

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confidence: 99%

Lesión neurológica incompleta ASIA B secundario a fractura luxación de L3-L4 por traumatismo de alta energía en región lumbar

2013

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In fracture dislocations of the lumbar region, two anatomical facts can help preserve neurological damage in patients, when compared with trauma in the cervical or thoracic region. Firstly, the spinal cord in adults extends only to the lower edge of the first lumbar vertebra, and secondly, the large vertebral space in this region gives ample space for the roots of the cauda equine. As a result, the nerve injury may be minimal, because the nerve roots in this region are accommodated in a larger area, with less content and space. This study presents the case of a 48 year-old male, a construction worker, who suffered a fall from a height of approximately 15 meters, directly hitting the lumbar region against a beam, and presenting pain and inability to move the legs. The patient was brought to the emergency room one hour after the accident, clinically assessed, submitted to x-rays and a CT scan, and diagnosed as having an ASIA B L3-L4 fracture dislocation. Three hours after the accident, reduction was performed via posterior transpedicular fixation. One week later, an anterior approach was performed. The patient progressed to ASIA C 24 hours after the first surgery. Three months later, the patient was functional with ASIA D and good sphincter control. The author's purpose is to show the results obtained by an intervention in the initial hours of the trauma, which helped promote the evolution from a nonfunctional injury to a functional one, with near-total recovery.Keywords: Dislocations/surgery; Lumbar vertebrae/injuries; Spinal fractures/surgery; Thoracic vertebrae/injuries; Accidental. RESUMO Nas fraturas-luxações da região lombar dois fatos anatômicos podem contribuir para o paciente apresentar menos danos neurológicos em comparação aos traumatismos na cervical ou torácica. Em primeiro lugar, a medula espinhal no adulto se estende apenas até o nível da

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Traumatic L4–L5 spondylolisthesis: case report

Cited by 38 publications

References 6 publications

Two-level traumatic lateral lumbar fracture and dislocation in a heavy equipment operator: a case report

Two-level traumatic lateral lumbar fracture and dislocation in a heavy equipment operator: a case report

Traumatic lumbar spondylolisthesis

Lesión neurológica incompleta ASIA B secundario a fractura luxación de L3-L4 por traumatismo de alta energía en región lumbar

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