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. 2010 Dec;4(2):128-31.
doi: 10.4184/asj.2010.4.2.128. Epub 2010 Nov 24.

Open Reduction without Fusion of Bilateral Jumped Lumbosacral Facet Dislocation Associated with Symphysis Pubis Separation and Cauda Equina Syndrome: Case Report

Sang-Bong Ko  1 , Sang-Wook Lee
Affiliations

Open Reduction without Fusion of Bilateral Jumped Lumbosacral Facet Dislocation Associated with Symphysis Pubis Separation and Cauda Equina Syndrome: Case Report

Sang-Bong Ko et al. Asian Spine J. 2010 Dec.

Abstract

This paper reports a rare case of a lumbosacral dislocation associated with symphysis pubis separation and cauda equina syndrome. A 39-year-old male who diagnosed traumatic lumbosacral dislocation underwent an open reduction without fusion. After an open reduction and internal fixation of a symphysis pubis separation, a missed lumbosacral dislocation was diagnosed and an open reduction was performed without fusion. Due to the symphysis pubis separation, the patient was not allowed weight bearing for 3 months, which then began from wheel chair ambulation. At the 6-month follow up evaluation, there was no back pain but the patient reported mild S1 nerve root sensory symptoms. Lumbosacral dislocation is common in high energy polytrauma patients and can be misdiagnosed. However, prompt reduction without fusion is a good alternative treatment.

Keywords: Lumbosacral facet dislocation; Non-fusion; Open reduction; Polyradiculopathy.

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Figures

Fig. 1
Fig. 1
Initial radiographic findings show (A) simple lumbar anterior-posterior and lateral X-ray views, (B) L4, 5 unilateral transverse process fracture on computed tomography (CT) imaging, (C) comminuted and displaced sacral fracture lines on CT imaging, (D) unilateral facet dislocation and symphysis pubis separation on three dimensional CT imaging and (E) symphysis pubis separation on initial simple pelvis anteroposterior X-ray view.
Fig. 2
Fig. 2
Computed tomography (CT) image shows missed unilateral facet joint dislocation initially (upper row). This CT image shows a more displaced sacral fracture gap after reduction of the symphysis pubis separation (lower row).
Fig. 3
Fig. 3
This computed tomography (CT) image shows reduced L5-S1 facet joint without fusion (upper row). This CT image shows a narrowed sacral fracture gap after reduction of the L5-S1 facet joint (lower row).
See this image and copyright information in PMC

References

    1. Schmid R, Reinhold M, Blauth M. Lumbosacral dislocation: a review of the literature and current aspects of management. Injury. 2010;41:321–328. - PubMed
    1. Szentirmai O, Seinfeld J, Beauchamp K, Patel V. Traumatic unilateral lumbosacral jumped facet without fracture in a child-presentation of a safe treatment strategy for a rare injury. Patient Saf Surg. 2008;2:29. - PMC - PubMed
    1. Vialle R, Charosky S, Rillardon L, Levassor N, Court C. Traumatic dislocation of the lumbosacral junction diagnosis, anatomical classification and surgical strategy. Injury. 2007;38:169–181. - PubMed
    1. Shen FH, Crowl A, Shuler TE, Feldenzer JA, Leivy SW. Delayed recognition of lumbosacral fracture dislocations in the multitrauma patient: the triad of transverse process fractures, unilateral renal contusion and lumbosacral fracture dislocation. J Trauma. 2004;56:700–705. - PubMed
    1. Reddy SJ, Al-Holou WN, Leveque JC, La Marca F, Park P. Traumatic lateral spondylolisthesis of the lumbar spine with a unilateral locked facet: description of an unusual injury, probable mechanism, and management. J Neurosurg Spine. 2008;9:576–580. - PubMed

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