不伴有神经损伤的胸椎骨折脱位.pdfVIP

JOURNAL OF MEDICAL CASE REPORTS Jiang et al. Journal of Medical Case Reports 2014, 8:343 /content/8/1/343CASE REPORT Open AccessSevere thoracic spinal fracture-dislocation without neurological symptoms and costal fractures: a case report and review of the literature Bing Jiang, Runcheng Zhu, Qingyan Cao and Hong Pan*Abstract Introduction: Only a high-energy force can cause thoracic spinal fracture-dislocation injuries, and such injuries should always be suspected in patients with polytrauma. The injury is usually accompanied by neurological symptoms. There are only a few cases of severe thoracic spinal fracture-dislocation without neurological symptoms in the literature, and until now, no case of severe thoracic spinal fracture-dislocation without neurological symptoms and without costal fractures has been reported. Case presentation: A 30-year-old Han Chinese man had T6 to T7 vertebral fracture and anterolateral dislocation without neurological symptoms and costal fractures. The three-dimensional reconstruction by computed tomography and magnetic resonance imaging indicated the injuries in detail. A patient with thoracic spinal fracture-dislocation without neurological symptoms inclines to further dislocation of the spine and secondary neurological injury; therefore, laminectomy, reduction and internal fixations with rods and screws were done. The outcome was good. Severe spinal fracture-dislocation without neurological symptoms should be evaluated in detail, especially with three-dimensional reconstruction by computed tomography. Although treatment is individualized, reduction and internal fixation are advised for the patient if the condition is suitable for operation. Conclusions: Severe thoracic spinal fracture-dislocation without neurological symptoms and costal fractures is frighteningly rare; an operation should be done if the patients condition permits. Keywords: Dislocation, Fracture, Thoracic vertebraeIntroduction The thoracic spine is stable because of ky