Treatment of Multiple Junctional Vertebra Fractures in a Single Case

We present a unique case of multiple junctional vertebra fractures in a single patient requiring surgical intervention, the variety of which has not yet been reported in the literature. A 15-year old female was admitted to our emergency department after a suicide attempt from jumping from the window of a five-floor building. On admission her general status was critical, Glasgow Coma Scale (GCS) was 6, and on painful stimuli she was able to move all four extremities. On her spinal CT, a C1 right arcus fracture, a C7 corpus fracture, an L3 and L5 burst fracture and a right sacrum fracture were detected. The patient also suffered from pneumothorax, pleural effusion and pulmonary contusions. After she was stable and extubated, she did not show any motor or sensory deficits. As the patient still had some pleural effusion and pulmonary contusions, posterior approaches were avoided at first and a C6-T1 anterior stabilization with mini plate-screws was performed. After her pulmonary problems resolved, a series of spinal instrumentation surgeries were performed over the following weeks. A case like this in which multiple traumatic junctional fractures were treated with different surgical techniques has not been reported in the literature before. It is important to emphasize if and when surgical intervention is needed. A multidisciplinary assessment of trauma surgeons, neurosurgeons and anesthesiologists is vital for forming a further treatment plan.