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Review
. 2014 Oct 14:8:343.
doi: 10.1186/1752-1947-8-343.

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

Bing Jiang, Runcheng Zhu, Qingyan Cao, Hong Pan  1
Affiliations
Review

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

Bing Jiang et al. J Med Case Rep. .

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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Figures

Figure 1
Figure 1
Three-dimensional reconstruction of computed tomography showed spinal fracture-dislocation of T6 to T7.
Figure 2
Figure 2
Three-dimensional reconstruction of computed tomography showed a fracture of right clavicle and non-fracture of ribs.
Figure 3
Figure 3
Magnetic resonance imaging showed spinal fracture-dislocation of T6 to T7.
Figure 4
Figure 4
Horizontal computed tomography scans showed a large bilateral hemothorax; fractures of bilateral pedicles of vertebral arch.
Figure 5
Figure 5
Horizontal computed tomography scans showed a large bilateral hemothorax; three vertebral levels in one cut.
Figure 6
Figure 6
Anteroposterior thoracic spine plain X-ray showed spinal fracture-dislocation of T6 to T7.
Figure 7
Figure 7
Anteroposterior thoracic spine plain X-ray showed realignment of the fractured-dislocated spine.
See this image and copyright information in PMC

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