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Spinal trauma with a complete anterior vertebral body dislocation: a report of three cases
R Vialle1, L Rillardon, A Feydy
1Department of Paediatric Orthopaedics, Université Pierre et Marie Curie-Paris6, Armand Trousseau Hospital, Paris, France. raphael.vialle@trs.aphp.fr
Study Design:
Retrospective review of three cases.
Objectives:
Severe trauma can be responsible for a complete spinal anterior dislocation with a 100% anterior slip of the vertebral body. Three cases of this uncommon lesion are reported.
Setting:
France.
Methods:
The data of three cases of complete spinal anterior dislocation with a 100% anterior slip of the vertebral body were retrospectively reviewed.
Results:
In all the cases, the vertebral dislocation was responsible for a severe neurological deficit and all patients had severe associated lesions. The diagnosis was made on plain radiographs. In one case of a multilevel injury, an extensive instrumented spinal fusion was necessary. In spite of the severe injury, two neurological deficits improved thanks to pedicular fractures, which widen the canal.
Conclusion:
The therapeutic goal is to achieve emergent vertebral alignment, neurological decompression and solid spinal fusion. A posterior facilitates this. Reduction of vertebral dislocation can be difficult to achieve and it is therefore mandatory to perform complete arthrectomy of the injured levels before reduction. Especially in young patients, severe disc lesions secondary to the wide vertebral displacement make it necessary to perform circumferential fusion.
