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Case Reports
. 2012:6:473-7.
doi: 10.2174/1874325001206010473. Epub 2012 Nov 2.

Unilateral lumbosacral dislocation: case report and a comprehensive review

Theodoros B Grivas  1 , Stamatios A Papadakis, Vassiliki Katsiva, George Koufopoulos, Vassilios Mouzakis
Affiliations
Case Reports

Unilateral lumbosacral dislocation: case report and a comprehensive review

Theodoros B Grivas et al. Open Orthop J. 2012.

Abstract

Lumbosacral fracture-dislocation is a rare occurrence. There are more than 73 cases reported in the English literature. We report on the imaging findings and surgical treatment in a patient suffered of unilateral traumatic L5-S1 dislocation associated with severe disruption of the posterior ligamentous complex. The patient underwent open reduction and stabilization of L4-S1 vertebrae with posterior instrumentation system. Open reduction and internal fixation was mandatory as post-traumatic ligamentous insufficiency would lead to abnormal motion. Operative treatment managed to produce a solid arthrodesis and restore stability of the lumbosacral junction. Follow-up revealed excellent results. This study reports a rare injury of the lumbosacral junction, and the literature concerning this unusual condition is extensively reviewed.

Keywords: Unilateral lumbosacral dislocation; case report; review.; surgery.

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Figures

Fig. (1)
Fig. (1)
Preoperative anteroposterior radiograph. The L5-S1interspinous distance is increased and the interspinous line shows a stepoff at this level. Avulsion of the L5 left transverse process is identified (arrow). The left facet joint is not well delineated.
Fig. (2)
Fig. (2)
Axial CT image shows avulsion of the L5 left transverse process and the lateral half of the pedicle.
Fig. (3)
Fig. (3)
(a, b) CT oblique coronal reformatted sequential images demonstrate the fracture at the root of right superior facet (RS) (arrow), the normal right inferior facet (RI), the normal (not fractured) LS, the fractured left transverse process (TP). The inferior part of LI is not identified (comminuted).
Fig. (4)
Fig. (4)
MRI of the lumbosacral spine. Sagittal T2-weighted midline and off-midline images showing epidural haematoma (curved arrow), extensive high-signal intensity changes in the posterior ligamentous complex (empty arrow) and discontinuity of the ligamentum flavum (straight arrow) suggestive of disruption. Notice mild posterior subluxation of L5 on S1.
Fig. (5)
Fig. (5)
Anteroposterior (a) and lateral (b) postoperative radiographs.
See this image and copyright information in PMC

References

    1. Tsirikos A, Saifuddin A, Noordeen MH, Tucker SK. Traumatic lumbosacral dislocation: report of two cases. Spine. 2004;29:E164–8. - PubMed
    1. Zoltan JD, Gilula LA, Murphy WA. Unilateral facet dislocation between the fifth lumbar and first sacral vertebrae. J Bone Joint Surg. 1979;61A:767–9. - PubMed
    1. Kramer KM, Levine AM. Unilateral facet dislocation of the lumbosacral junction. J Bone Joint Surg. 1989;71A:1258–61. - PubMed
    1. Shen FH, Crowl A, Shuler TE, Feldenzer JA, Leivy SW. Delayed recognition of lumbosacral fracture dislocation in the multitrauma patient, the triad of transverse process fractures unilateral renal contusion and lumbosacral fracture dislocation. J Orthop Trauma . 2004;56:700–5. - PubMed
    1. Vialle R, Wolff S, Pauthier F, et al. Traumatic lumbosacral dislocation: four cases and review of literature. Clin Orthop. 2004; 419:91–7. - PubMed

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