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Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures: a case report and review of the literature.

Jiang B, Zhu R, Cao Q, Pan H - J Med Case Rep (2014)

Bottom Line: A patient with thoracic spinal fracture-dislocation without neurological symptoms inclines to further dislocation of the spine and secondary neurological injury; therefore, laminectomy, reduction and internal fixations with rods and screws were done.The outcome was good.Although treatment is individualized, reduction and internal fixation are advised for the patient if the condition is suitable for operation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedic Surgery, Anqing Hospital, Anhui Medical University, 352th Renmin Road, Anqing City, Anhui Province 246003, China. 15505600808@163.com.

ABSTRACT

Introduction: Only a high-energy force can cause thoracic spinal fracture-dislocation injuries, and such injuries should always be suspected in patients with polytrauma. The injury is usually accompanied by neurological symptoms. There are only a few cases of severe thoracic spinal fracture-dislocation without neurological symptoms in the literature, and until now, no case of severe thoracic spinal fracture-dislocation without neurological symptoms and without costal fractures has been reported.

Case presentation: A 30-year-old Han Chinese man had T6 to T7 vertebral fracture and anterolateral dislocation without neurological symptoms and costal fractures. The three-dimensional reconstruction by computed tomography and magnetic resonance imaging indicated the injuries in detail. A patient with thoracic spinal fracture-dislocation without neurological symptoms inclines to further dislocation of the spine and secondary neurological injury; therefore, laminectomy, reduction and internal fixations with rods and screws were done. The outcome was good. Severe spinal fracture-dislocation without neurological symptoms should be evaluated in detail, especially with three-dimensional reconstruction by computed tomography. Although treatment is individualized, reduction and internal fixation are advised for the patient if the condition is suitable for operation.

Conclusions: Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures is frighteningly rare; an operation should be done if the patient's condition permits.

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Three-dimensional reconstruction of computed tomography showed a fracture of right clavicle and non-fracture of ribs.
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Figure 2: Three-dimensional reconstruction of computed tomography showed a fracture of right clavicle and non-fracture of ribs.

Mentions: A 30-year-old Han Chinese man was riding his motorcycle at 80.5km/hour when he collided with an oncoming car. He complained of back pain and right shoulder pain and was admitted to a local hospital. He sustained double inferior lung contusion with a few hemothoraces, fractures of right clavicle and vertebrae T6 to T7 inclusive. After 6 hours, he was transferred to our hospital. On clinical examination, there was no neurological deficit. A three-dimensional reconstruction of computed tomography showed spinal fracture-dislocation of T6 to T7 (Figure 1), a fracture of right clavicle whereas fracture of ribs was not found (Figure 2), magnetic resonance imaging showed spinal fracture-dislocation of T6 to T7 (Figure 3), horizontal computed tomography scans showed a large bilateral hemothorax (Figures 4 and 5), fractures of bilateral pedicles of vertebral arch (Figure 4), three vertebral levels in one cut (Figure 5), and anteroposterior thoracic spine plain X-ray showed spinal fracture-dislocation of T6 to T7 (Figure 6) and realignment of his fractured-dislocated spine (Figure 7).


Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures: a case report and review of the literature.

Jiang B, Zhu R, Cao Q, Pan H - J Med Case Rep (2014)

Three-dimensional reconstruction of computed tomography showed a fracture of right clavicle and non-fracture of ribs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4202694&req=5

Figure 2: Three-dimensional reconstruction of computed tomography showed a fracture of right clavicle and non-fracture of ribs.
Mentions: A 30-year-old Han Chinese man was riding his motorcycle at 80.5km/hour when he collided with an oncoming car. He complained of back pain and right shoulder pain and was admitted to a local hospital. He sustained double inferior lung contusion with a few hemothoraces, fractures of right clavicle and vertebrae T6 to T7 inclusive. After 6 hours, he was transferred to our hospital. On clinical examination, there was no neurological deficit. A three-dimensional reconstruction of computed tomography showed spinal fracture-dislocation of T6 to T7 (Figure 1), a fracture of right clavicle whereas fracture of ribs was not found (Figure 2), magnetic resonance imaging showed spinal fracture-dislocation of T6 to T7 (Figure 3), horizontal computed tomography scans showed a large bilateral hemothorax (Figures 4 and 5), fractures of bilateral pedicles of vertebral arch (Figure 4), three vertebral levels in one cut (Figure 5), and anteroposterior thoracic spine plain X-ray showed spinal fracture-dislocation of T6 to T7 (Figure 6) and realignment of his fractured-dislocated spine (Figure 7).

Bottom Line: A patient with thoracic spinal fracture-dislocation without neurological symptoms inclines to further dislocation of the spine and secondary neurological injury; therefore, laminectomy, reduction and internal fixations with rods and screws were done.The outcome was good.Although treatment is individualized, reduction and internal fixation are advised for the patient if the condition is suitable for operation.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopedic Surgery, Anqing Hospital, Anhui Medical University, 352th Renmin Road, Anqing City, Anhui Province 246003, China. 15505600808@163.com.

ABSTRACT

Introduction: Only a high-energy force can cause thoracic spinal fracture-dislocation injuries, and such injuries should always be suspected in patients with polytrauma. The injury is usually accompanied by neurological symptoms. There are only a few cases of severe thoracic spinal fracture-dislocation without neurological symptoms in the literature, and until now, no case of severe thoracic spinal fracture-dislocation without neurological symptoms and without costal fractures has been reported.

Case presentation: A 30-year-old Han Chinese man had T6 to T7 vertebral fracture and anterolateral dislocation without neurological symptoms and costal fractures. The three-dimensional reconstruction by computed tomography and magnetic resonance imaging indicated the injuries in detail. A patient with thoracic spinal fracture-dislocation without neurological symptoms inclines to further dislocation of the spine and secondary neurological injury; therefore, laminectomy, reduction and internal fixations with rods and screws were done. The outcome was good. Severe spinal fracture-dislocation without neurological symptoms should be evaluated in detail, especially with three-dimensional reconstruction by computed tomography. Although treatment is individualized, reduction and internal fixation are advised for the patient if the condition is suitable for operation.

Conclusions: Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures is frighteningly rare; an operation should be done if the patient's condition permits.

Show MeSH
Related in: MedlinePlus