Floating Thoracic Spine After Double, Noncontiguous Three-Column Spinal Fractures

Area of Science:

• Orthopedic Surgery
• Trauma Surgery
• Spinal Biomechanics

Background:

• Double, noncontiguous, 3-column spinal injuries are rare, high-energy trauma events.
• These injuries create two separate 3-column lesions with an unstable floating spinal segment.
• Previous reports involved multiple spinal regions; this is the first thoracic-only case.

Observation:

• A 48-year-old male sustained a double-level thoracic spinal injury with a floating segment after a 30-foot fall.
• Standard pedicle instrumentation (3 above, 2 below) proved inadequate for thoracic spine stabilization.

Findings:

• The case highlights a unique presentation of double-level thoracic spinal injury.
• Standard surgical fixation methods may not provide sufficient stability for this rare injury pattern.

Implications:

• Evaluation and surgical management require careful consideration for these complex fractures.
• An extended anteroposterior approach may be necessary to prevent hardware failure and spinal deformity.
• This case expands understanding of rare spinal trauma and informs treatment strategies.