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Fracture-dislocation at the thoracolumbar junction in an infant with locked vertebrae. A case report
1Department of Orthopaedics, Seth G. S. Medical College, Bombay, India.
Insights
A rare infant thoracolumbar spine fracture-dislocation in a 9-month-old showed partial neurologic recovery after surgical fusion. This case highlights unique infantile spinal biomechanics.
Area of Science:
- Pediatric Orthopedics
- Spinal Surgery
- Pediatric Traumatology
Background:
- Thoracolumbar junction fracture-dislocation is exceptionally rare in infants, contrasting with common upper cervical spine injuries.
- Severe shear injuries in infants typically present with different spinal level involvement.
- Incomplete neurologic injury following such severe trauma is an uncommon presentation.
Observation:
- A 9-month-old infant presented with a fracture-dislocation at the thoracolumbar junction, characterized by locked vertebral bodies.
- The infant exhibited signs suggestive of incomplete neurologic injury.
- The case involved a retrospective review and personal examination over a 6-month follow-up period.
Findings:
- Surgical intervention included open reduction and posterior spinal fusion.
- The patient demonstrated partial neurologic recovery post-operatively.
- Spinal stability was maintained throughout the 6-month follow-up period.
Implications:
- This case underscores the rarity of thoracolumbar fracture-dislocation in infancy.
- The unique anatomical and biomechanical properties of the infant spine likely contribute to this rarity.
- Understanding these features is crucial for diagnosing and managing pediatric spinal trauma.
Study Design:
A retrospective, single-patient case report.
Objectives:
To report on a 9-month-old infant with fracture-dislocation at the thoracolumbar junction with locking of vertebral bodies, probably with incomplete neurologic injury and partial postoperative recovery.
Summary Of Background Data:
Fracture-dislocation at the thoracolumbar junction is rare in infants, the upper cervical spine being the level usually affected. Incomplete neurologic injury is uncommon after such a severe shear injury.
Methods:
The patient was followed through personal examination and chart review from initial presentation to 6 months after the injury.
Results:
Open reduction with posterior spinal fusion was followed by partial neurologic recovery and a stable spine over 6-month follow-up.
Conclusions:
Fracture-dislocation at the thoracolumbar junction is rare in infancy. This is probably due to unique anatomic and biomechanical features of the spine in infancy.