Severe Dislocation Of Thoracic Spine With No Neurologic Deficit


A 29-year-old patient with no past medical history was brought to the emergency department after a motorcycle accident.

The patient presented with no signs of mental trauma or emotional disorientation. He was breathing normally and his pulse was rhythmic and preserved and blood pressure was 90/40 mmHg. In addition, there were no significant pathological findings other than sensitivity in the anterior portion of the left thigh.

A 30 cm fracture was present in the left iliolingual region (L-1) with iliac crest exposure. The fracture was comminuted type and involved the soft tissues. In addition to this, a grade II (Gustilo and Anderson classification), open distal tibial fracture was also present.

Further investigations including an ultrasound scan was performed. The scans did not show any pleural, pericardial and abdominal fluid. Additionally, a CT scan was performed which confirmed the diagnosis of Fracture-dislocation CA3 at T10 and A0 at T10 level (AO classification), a 10th rib fracture, left iliac open fracture.

Treatment plan

The patient was advised early surgical treatment, open reduction and fixation with pedicle screws at T8-T12, external fixation to the right tibia and Friedrich on left iliolingual wound. Furthermore, a second surgery was performed 9 days after the first surgery. The procedure included open reduction internal fixation (ORIF) of external tibial plateau fracture of right knee with two cannulated screws, ligamentoplasty of right knee and ORIF of right distal tibial fracture.

Fracture or dislocations of the thoracic or lumbar spine after high impact trauma often causes neurologic deficits. However, the 29-year-old presented with no neurologic deficits even three years after the surgical procedures. Follow-up showed that he progressed satisfactorily.


Fracture-Dislocation of the Upper Thoracic Spine without Neurologic Associated Injury: Two Cases Report

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Dr. Aiman Shahab is a dentist with a bachelor’s degree from Dow University of Health Sciences. She is an experienced freelance writer with a demonstrated history of working in the health industry. Skilled in general dentistry, she is currently working as an associate dentist at a private dental clinic in Karachi, freelance content writer and as a part time science instructor with Little Medical School. She has also been an ambassador for PDC in the past from the year 2016 – 2018, and her responsibilities included acting as a representative and volunteer for PDC with an intention to make the dental community of Pakistan more connected and to work for benefiting the underprivileged. When she’s not working, you’ll either find her reading or aimlessly walking around for the sake of exploring. Her future plans include getting a master’s degree in maxillofacial and oral surgery, settled in a metropolitan city of North America.


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