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Related Experiment Videos

Posttraumatic total dislocation of the upper thoracic spine.

K Sridhar1, M C Vasudevan, B Ramamurthi

  • 1Postgraduate Institute of Neurological Surgery, Dr. A. Lakshmipathi Neurosurgical Centre, VHS Medical Centre, TTTI Post Chennai, Madras, India.

Surgical Neurology
|March 20, 2004
PubMed
Summary

Upper thoracic spine injuries can be missed on X-rays, especially without neurological symptoms. Early investigation is crucial for suspected cervico-thoracic dislocations to prevent delayed complications.

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Area of Science:

  • Traumatology
  • Neurosurgery
  • Radiology

Background:

  • Upper thoracic spine injuries are challenging to visualize on plain radiographs.
  • Missed injuries are common in busy trauma settings, particularly when patients lack neurological deficits.
  • Delayed presentation of upper thoracic dislocations can exacerbate injury severity.

Observation:

  • A 19-year-old female presented with progressive paraparesis 18 hours post-scalp avulsion.
  • Imaging confirmed a T1-T2 complete dislocation with spinal cord compression.
  • The patient underwent emergency surgical decompression and spinal reconstruction.

Findings:

  • Immediate neurologic improvement was observed post-surgery.
  • The patient achieved a normal neurological status at follow-up.

Related Experiment Videos

  • This case underscores the diagnostic challenges of upper thoracic spine injuries.

    • Implications:

    • Physicians should maintain a low threshold for investigating cervico-thoracic dislocations.
    • Radiographic limitations in visualizing the upper thoracic spine necessitate heightened clinical suspicion.
    • Consider delayed progressive dislocation in patients with potential spinal trauma, even without initial symptoms.