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Document Type

Case Report

Abstract

Background data: Traumatic spondyloptosis is a rare spinal injury, especially in the absence of a neurologic deficit. Urgent and safe management of this injury poses a significant burden on the spine surgeon. Purpose: To report a case of complete fracture-dislocation at L4-5 without neurologic deficit. Study design: A case report. Patients and Methods: A 34-year-old male who works as a manual worker presented to our emergency department after a heavy object fell on his back. He was diagnosed with traumatic L4-L5 spondyloptosis without a neurologic deficit. The body of L4 with the spinal column above was totally displaced in front of the body of L5. The posterior elements of L3 and L4 were fractured, causing spontaneous decompression of the neural tissue. He underwent urgent surgery the next day in the form of posterior instrumentation, reduction, and interbody fusion. Results: The patient’s neurologic function remained unchanged after surgery and throughout the postoperative period of 9 months. Conclusion: Complete fracture-dislocation of the lumbar spine is a rare injury, especially without a neurologic deficit. This could be explained by the spontaneous neurologic decompression achieved through fractures in the posterior elements. Urgent surgical intervention is of paramount importance in preserving neurologic function and achieving good clinical results.

Keywords

Traumatic spondyloptosis, Complete fracture-dislocation, Spontaneous neurologic decompression.

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