Management of lumbar translocation injuries: case reports

Lumbar translocation (complete lumbar dislocation) injuries constitute a severe and highly unstable form of thoraco-lumbar spinal injury and are uncommon. Adequate management of such injuries includes removing the neural tissue compression and realigning and stabilizing the spine. Computerized axial tomographic scans of the spine are very dramatic in demonstrating encroachment on the spinal canal by bony fragments. We report two cases of lumbar translocation injuries with favorable outcomes. The patients were initially managed with halo-femoral traction, resulting in spinal reduction and eliminating the need for acute surgical intervention, and subsequently underwent posterior fusion for stability. Anterior decompression was done at a later date as computed tomography showed retropulsed intracanalicular bone fragments. The use of Harrington rod instrumentation and realignment of the spine did not free the canal of bony fragments and, hence, decompression was required.