A Case  Report on Extruded Disc Acting as Buttonhole Preventing Reduction in Traumatic Fracture and Lateral Dislocation of L1-l2 Vertebrae

 

What to Learn from this Article?

Unusual Cause of Irreducibilty of Traumatic Spine Fracture.


Case Report |  Volume 4 | Issue 3 | JOCR July-Sep 2014 | Page 49-52 | Sundaram PS, Kanniyan K, Ramanujam K.  DOI: 10.13107/jocr.2250-0685.196


Authors: Sundaram PS[1], Kanniyan K[1], Ramanujam K[1]

[1] Department of Orthopaedics, Saveetha Medical College Hospital, Thandalam, Chennai., India.

Address of Correspondence:

Dr.P.Shanmuga Sundaram, Associate Professor, Department of Orthopaedics, Saveetha Medical College Hospital, Thandalam, Chennai. E-Mail: shanmu_ps@yahoo.com


Abstract

Introduction: There is a scanty literature support describing the incidence, mechanism of lateral dislocations of thoracolumbar spine and its management describing the reduction techniques. Hereby we present an interesting case of extruded disc acting as buttonhole preventing the reduction of lateral dislocation of L1-L2 vertebrae and this would be the first of its variety to be described ever in literature.

Case Report: A 30 year old female was referred to our hospital on post trauma day 7 with bilateral fascet fracture and lateral dislocation of L1-L2 vertebrae and fracture humerus on right arm following a road traffic accident. She presented with clinical signs consistent of cauda equina lesion. She underwent surgical reduction and TLIF L1-L2. On one year follow-up X-Rays showed maintenance of dorsolumbar saggital alignment without collapse.

Conclusion: Dislocations of spine are three column injuries, are highly unstable requiring surgical stabilisation. Posterior instrumentation is the routinely followed technique to achieve reduction and for posterolateral fusion. In this case lateral dislocation was reduced only after removal of the laterally extruded disc. After complete discectomy TLIF was considered a good option for restoring disc space height and maintaining saggital balance.

Keywords: Lateral dislocation of L1-L2, TLIF, extruded disc, posterior stabilization, posterior lateral fusion.


How to Cite This Article: Sundaram PS, Kanniyan K, Ramanujam K. A Case Report on Extruded Disc Acting as Buttonhole Preventing Reduction in Traumatic Fracture and Lateral Dislocation of L1-l2 Vertebrae. Journal of Orthopaedic Case Reports 2014 July-Sep;4(3): 49-52. Available from: http://www.jocr.co.in/wp/2014/07/11/2250-0685-196-abstract/

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