Surgical Management of an Unstable Lumbar Fracture-Dislocation—A Case Report

O. Rezaee, R. Salar, R. Jabari, A. Shams Akhtari

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Emergency Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Neurosugery Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

DOI: 10.4236/ojmn.2014.43024                

Abstract

The lumbar spine is the most common sites for fractures because of the high mobility of the lumbar spine. A spinal cord injury usually begins with a sudden, traumatic blow to the spine that fractures or dislocates vertebrae. A 32-year-old man presented to us after traffic accident. In our patient, unstable fracture-dislocation of the lumbar spine at the L2-L3 level due to traffic accident occurred. The vertebral bodies were fractured and the anterior dislocation happened without spinal cord injury. The patient was a candidate for an open reduction and internal fixation surgery. The posterolateral approach was performed. After insertion of all the pedicle screws, the rods were transversally placed on L2-L3-L4 vertebral bodies and tightened. The reduction of the dislocations was carried out by pushing downwards (foreside) L2 and L4 vertebras and upwards (backside) L3 vertebrae, simultaneously. After securing the reduction of the dislocations, the rods were opened and placed along the spinal column and tightened. This technique is more effective when the pedicle of fractured vertebrae is intact.

Keywords

Fracture-Dislocations, Lumbar Spine, Posterolateral Approach, Reduction, Fixation

Conflicts of Interest

The authors declare no conflicts of interest.

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