Management of fracture and lateral dislocation of the thoracic spine without any neurological deficits: three case reports and review of the literature.

BACKGROUND: Fracture and dislocation of the thoracic spine without neurological deficits are rare. Most of these cases are managed by non-operative methods or a posterior approach surgery. AIM: To report three cases of fracture and lateral dislocation of the thoracic spine without neurological deficits and review the literature on the management strategy. METHODS: Three patients who suffered thoracic spinal fracture and lateral dislocation without spinal cord injury underwent anterior decompression, reduction and internal fixation. The case series describe their management, surgical intervention and their follow-up. RESULTS: Reduction was satisfactory, none of the patients had any postoperative neurological deficits. Fusion was successful, and vertebral column alignment was maintained at the last follow-up. CONCLUSION: An anterior approach facilitated adequate decompression, reduction and stabilization through instrumentation in this series of injury without neurological deficits.

Thoracic Fracture-Dislocations Without Spinal Cord Injury: Two Cases Reports / 대한척추외과학회지

Thoracic fracture-dislocations reportedly lead to an 80% incidence of complete paraplegia. Thus, thoracic fracture-dislocations without cord injury are uncommon. There are a few cases of thoracic fracture-dislocations in which the neural sparing status was associated with separation of the posterior spinal structures, such as the pedicles and laminae. The authors experienced two cases of thoracic fracture-dislocations without spinal cord injury: one was a 50-year-old man who fell from the fourth floor of a building and sustained a T6-7 fracture-dislocation; and the other was a 43-year-old man who was involved in motorcycle accident and sustained a T12 fracture-dislocation. Segmental spinal instrumentation and fusion without open reduction was performed in each of the two cases and there has not been any abnormality detected on neurological examination at a minimum follow-up period of 2 years.