Korean J Neurotrauma.  2020 Oct;16(2):313-319. 10.13004/kjnt.2020.16.e28.

Fracture-dislocation of L5 Combined with Multi-level Traumatic Spondylolisthesis of the Lower Lumbar Spine Treated via the Posterior-only Approach: A Case Report

• Park GT
• Yu D
• Kim SW
• Jeon I

• KMID: 2523141
• DOI: http://doi.org/10.13004/kjnt.2020.16.e28

Abstract

Fracture-dislocation of the lower lumbar spine, which is commonly caused by high-impact trauma and can lead to instability in the spine, is relatively rare. Surgical treatment is indicated to restore spinal balance, weight-bearing ability, and decompression of the neural elements. There are various available surgical options, including the posterior-only or anterior-only approaches, or a combination of them. However, there is still no definite classification and treatment strategy for fracture-dislocation of the lower lumbar spine. In this report, we describe a 65-year-old man presenting cauda equina syndrome caused by a fracture-dislocation of L5 combined with multi-level traumatic spondylolisthesis of the lower lumbar spine. The patient was treated via the posterior-only approach with neural decompression and anterior reconstruction with posterior instrumentation. We discuss the reasons why the posterior-only approach was decided upon and several meaningful points during the surgery in detail.

Keyword

Fifth lumbar vertebra; Corpectomy; Posterior approach; Fracture-dislocation; Lumbosacral