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Traumatic lumbosacral dislocation: report of two cases.
Spine (Phila Pa 1976) 2004; 29(8):E164-8S

Abstract

STUDY DESIGN

A retrospective study of 2 patients with traumatic lumbosacral dislocation.

OBJECTIVES

To discuss the difficulty in making diagnosis and the effect of surgical treatment.

SUMMARY OF BACKGROUND DATA

Traumatic lumbosacral dislocation is an uncommon injury, which creates diagnostic difficulty and is typically managed by open reduction internal fixation of the lumbosacral spine.

METHODS

Medical notes and imaging of the 2 patients were reviewed.

RESULTS

Both patients were engaged in high-energy accidents and had concomitant injuries. Patient 1 was initially misdiagnosed as having L5 lytic spondylolisthesis and was treated with a lumbar corset. She developed progressive low back and left leg pain. Eleven months after the accident, a bilateral lumbosacral dislocation with right S1 superior facet fracture, disc rupture, posterior soft tissue disruption, and a resultant Grade 4 L5-S1 traumatic spondylolisthesis was identified. She underwent open reduction, followed by a staged anteroposterior spinal arthrodesis using instrumentation with excellent results. Patient 2 sustained a unilateral L5-S1 facet dislocation without neurologic deficit, which reduced spontaneously. The evaluation demonstrated a grossly disturbed posterior ligamentous complex adjacent to the lumbosacral articulation. A combined anteroposterior spinal fusion with instrumentation was performed with favorable outcome.

CONCLUSION

Meticulous clinical examination and careful imaging assessment, including CT and MRI, assist an early diagnosis in cases of lumbosacral dislocation. Open reduction and circumferential bony fusion restore segmental stability and painless function.

Authors+Show Affiliations

Department of Spinal Surgery, Royal National Orthopaedic Hospital NHS Trust, Middlesex, UK. atsirikos@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

15083005

Citation

Tsirikos, Athanasios I., et al. "Traumatic Lumbosacral Dislocation: Report of Two Cases." Spine, vol. 29, no. 8, 2004, pp. E164-8.
Tsirikos AI, Saifuddin A, Noordeen MH, et al. Traumatic lumbosacral dislocation: report of two cases. Spine. 2004;29(8):E164-8.
Tsirikos, A. I., Saifuddin, A., Noordeen, M. H., & Tucker, S. K. (2004). Traumatic lumbosacral dislocation: report of two cases. Spine, 29(8), pp. E164-8.
Tsirikos AI, et al. Traumatic Lumbosacral Dislocation: Report of Two Cases. Spine. 2004 Apr 15;29(8):E164-8. PubMed PMID: 15083005.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Traumatic lumbosacral dislocation: report of two cases. AU - Tsirikos,Athanasios I, AU - Saifuddin,Asif, AU - Noordeen,M Hilali, AU - Tucker,Stewart K, PY - 2004/4/15/pubmed PY - 2004/5/1/medline PY - 2004/4/15/entrez SP - E164 EP - 8 JF - Spine JO - Spine VL - 29 IS - 8 N2 - STUDY DESIGN: A retrospective study of 2 patients with traumatic lumbosacral dislocation. OBJECTIVES: To discuss the difficulty in making diagnosis and the effect of surgical treatment. SUMMARY OF BACKGROUND DATA: Traumatic lumbosacral dislocation is an uncommon injury, which creates diagnostic difficulty and is typically managed by open reduction internal fixation of the lumbosacral spine. METHODS: Medical notes and imaging of the 2 patients were reviewed. RESULTS: Both patients were engaged in high-energy accidents and had concomitant injuries. Patient 1 was initially misdiagnosed as having L5 lytic spondylolisthesis and was treated with a lumbar corset. She developed progressive low back and left leg pain. Eleven months after the accident, a bilateral lumbosacral dislocation with right S1 superior facet fracture, disc rupture, posterior soft tissue disruption, and a resultant Grade 4 L5-S1 traumatic spondylolisthesis was identified. She underwent open reduction, followed by a staged anteroposterior spinal arthrodesis using instrumentation with excellent results. Patient 2 sustained a unilateral L5-S1 facet dislocation without neurologic deficit, which reduced spontaneously. The evaluation demonstrated a grossly disturbed posterior ligamentous complex adjacent to the lumbosacral articulation. A combined anteroposterior spinal fusion with instrumentation was performed with favorable outcome. CONCLUSION: Meticulous clinical examination and careful imaging assessment, including CT and MRI, assist an early diagnosis in cases of lumbosacral dislocation. Open reduction and circumferential bony fusion restore segmental stability and painless function. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/15083005/Traumatic_lumbosacral_dislocation:_report_of_two_cases_ L2 - http://Insights.ovid.com/pubmed?pmid=15083005 DB - PRIME DP - Unbound Medicine ER -