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Traumatic L5 Posterolateral Spondyloptosis: A Case Report and Review of the Literature.

Gabel BC, Curtis E, Gonda D, Ciacci J - Cureus (2015)

Bottom Line: Only a few case reports have shown retrolisthesis of the fractured fragment over the inferior vertebral body.The patient presented with paraplegia and bowel and bladder incontinence.The patient did not regain function in his distal lower extremities postoperatively.

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Affiliation: Neurosurgery, University of California, San Diego.

ABSTRACT
Traumatic retrolisthesis of the lumbar spine is a rare clinical entity. Only a few case reports have shown retrolisthesis of the fractured fragment over the inferior vertebral body. Fracture dislocations of the spine are unstable injuries that require operative fixation to restore alignment and prevent progressive deformity. We present the case of a traumatic L5-S1 fracture dislocation with retrolisthesis of the L5 vertebral body over the superior aspect of S1 managed with anterior, middle, and posterior column reconstruction. The patient presented with paraplegia and bowel and bladder incontinence. Retrolisthesis fracture dislocations injuries are rare, and as such, there are no guidelines regarding their management. In our case, we performed an L5 vertebrectomy with anterior, middle, and posterior column reconstruction via a posterior approach using a lumbosacral-pelvic construct. The patient did not regain function in his distal lower extremities postoperatively.

No MeSH data available.


Related in: MedlinePlus

Preoperative parasagittal MRIThis is a preoperative parasagittal MRI showing gross ligamentous instability and complete obliteration of the thecal sac at the level of injury. 
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FIG4: Preoperative parasagittal MRIThis is a preoperative parasagittal MRI showing gross ligamentous instability and complete obliteration of the thecal sac at the level of injury. 

Mentions: On arrival, the patient had massive trauma to the right lower quadrant of the abdomen and was taken to the operating room emergently for exploratory laparotomy. After resuscitation, imaging of his neural axis with both CT and MRI revealed a posterolateral retrolisthesis of L5 over S1 with a complete thecal sac obliteration (Figures 1-4). There were additional, less severe fractures at the L3 and L4 vertebral levels. Pneumorachis was also apparent on imaging, which tracked to the C6 and C7 spinal levels. However, there were no additional fractures seen in the thoracic or cervical spine.


Traumatic L5 Posterolateral Spondyloptosis: A Case Report and Review of the Literature.

Gabel BC, Curtis E, Gonda D, Ciacci J - Cureus (2015)

Preoperative parasagittal MRIThis is a preoperative parasagittal MRI showing gross ligamentous instability and complete obliteration of the thecal sac at the level of injury. 
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494538&req=5

FIG4: Preoperative parasagittal MRIThis is a preoperative parasagittal MRI showing gross ligamentous instability and complete obliteration of the thecal sac at the level of injury. 
Mentions: On arrival, the patient had massive trauma to the right lower quadrant of the abdomen and was taken to the operating room emergently for exploratory laparotomy. After resuscitation, imaging of his neural axis with both CT and MRI revealed a posterolateral retrolisthesis of L5 over S1 with a complete thecal sac obliteration (Figures 1-4). There were additional, less severe fractures at the L3 and L4 vertebral levels. Pneumorachis was also apparent on imaging, which tracked to the C6 and C7 spinal levels. However, there were no additional fractures seen in the thoracic or cervical spine.

Bottom Line: Only a few case reports have shown retrolisthesis of the fractured fragment over the inferior vertebral body.The patient presented with paraplegia and bowel and bladder incontinence.The patient did not regain function in his distal lower extremities postoperatively.

View Article: PubMed Central - HTML - PubMed

Affiliation: Neurosurgery, University of California, San Diego.

ABSTRACT
Traumatic retrolisthesis of the lumbar spine is a rare clinical entity. Only a few case reports have shown retrolisthesis of the fractured fragment over the inferior vertebral body. Fracture dislocations of the spine are unstable injuries that require operative fixation to restore alignment and prevent progressive deformity. We present the case of a traumatic L5-S1 fracture dislocation with retrolisthesis of the L5 vertebral body over the superior aspect of S1 managed with anterior, middle, and posterior column reconstruction. The patient presented with paraplegia and bowel and bladder incontinence. Retrolisthesis fracture dislocations injuries are rare, and as such, there are no guidelines regarding their management. In our case, we performed an L5 vertebrectomy with anterior, middle, and posterior column reconstruction via a posterior approach using a lumbosacral-pelvic construct. The patient did not regain function in his distal lower extremities postoperatively.

No MeSH data available.


Related in: MedlinePlus