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Extension Injury of the Thoracolumbar Spine

Nabeshima, Yuji, MD*; Iguchi, Tetsuhiro, MD*; Matsubara, Nobuaki, MD*; Kinoshita, Seiji, MD; Kurosaka, Masahiro, MD; Mizuno, Kosaku, MD

Case Report

Study Design. This is a report of a patient with a rare fracture in the thoracolumbar spine.

Objectives. To illustrate the previously undescribed fracture in the thoracolumbar spine and to propose a new mechanism of this rare lesion with a literature review.

Summary of Background Data. Extension injury of the thoracolumbar spine is uncommon. Although there have been several reports of hyperextension injuries in the thoracolumbar spine, the injury mechanism of the present case was different from those in the previously reported cases.

Methods. The clinical findings, roentgenographic appearance, treatment, and follow-up result were presented, and the mechanism of this lesion was analyzed.

Results. Physical examination revealed no neurologic deficit. Radiographs showed the oblique fracture line extended from the middle region of the L1-L2 disc to the posteroinferior edge of the L2 vertebral body, with the widening of bilateral L2-L3 facet joints. The patient was treated conservatively with a successful outcome. Two years after his injury, the patient had resumed his previous activity completely.

Conclusions. The authors considered that the mechanism of this rare injury was a combination of hyperextension force and axial loading.

From the *Department of Orthopaedic Surgery, Hyogo Prefectural Kakogawa Hospital, Kakogawa, Japan, and †the Department of Orthopaedic Surgery, Kobe University School of Medicine, Kobe, Japan.

Acknowledgment date: April 5, 1996.

Acceptance date: June 13, 1996.

Device status category: 1.

Address reprint requests to: Yuji Nabeshima, MD; Department of Orthopaedic Surgery; Hyogo Prefectural Kakogawa Hospital; 770 Awazu; Kakogawa-cho, Kakogawa 675; Japan.

© Lippincott-Raven Publishers.