Arquivos Brasileiros de Neurocirurgia: Brazilian Neurosurgery 2016; 35(03): 244-247
DOI: 10.1055/s-0036-1592104
Case Report | Relato de Caso
Thieme Publicações Ltda Rio de Janeiro, Brazil

Severe Lateral Thoracic Fracture-Dislocation without Neurological Deficit – Case Report

Fratura torácica com luxação lateral grave sem déficit neurológico – relato de caso
Catarina C. Lins
1   Division of Neurosurgery, Hospital Municipal Dr. Mario Gatti, Campinas - SP, Brazil
,
Diego T. do Prado
2   Clinics Hospital, Faculdade de Medicina, Universidade de São Paulo, São Paulo, São Paulo, Brazil
,
Andrei F. Joaquim
1   Division of Neurosurgery, Hospital Municipal Dr. Mario Gatti, Campinas - SP, Brazil
3   Department of Neurology, Universidade Estadual de Campinas - Unicamp, São Paulo, Brazil
,
Yvens B. Fernandes
1   Division of Neurosurgery, Hospital Municipal Dr. Mario Gatti, Campinas - SP, Brazil
3   Department of Neurology, Universidade Estadual de Campinas - Unicamp, São Paulo, Brazil
,
Paulo A. T. Kimaid
4   Department of Clinical Neurology, Division of Neurophysiology, Universidade Estadual de Campinas - Unicamp, Campinas, Brazil
› Author Affiliations
Further Information

Publication History

24 November 2015

04 August 2016

Publication Date:
14 September 2016 (online)

Abstract

Introduction A case report of a thoracic fracture-dislocation (T11–T12) without neurological deficit is presented.

Objective Report the diagnosis and treatment of a traumatic severe fracture with lateral dislocation at the thoracolumbar junction without neurological deficit.

Background Fracture-dislocation of the thoracic spine without neurological deficit is a rare lesion. We retrieved only 15 cases reported in the literature. Surgical treatment with spinal decompression, fusion and realignment is the treatment of choice.

Case A 40-year-old man suffered a bicycle accident and was admitted with severe back pain but neurologically intact. He was treated with a wide laminectomy and spinal cord decompression followed by correction of his deformity using pedicle screw instrumentation and rod maneuvers.

Results After three days, the patient was able to walk, and after one month he had just mild back pain, but was neurologically intact, and was able to return to his usual daily activities. After six months, he was neurologically intact and performing routine physical activities.

Conclusions Fracture-dislocation of the thoracic spine without neurological deficit is a rare injury. A good outcome can be obtained with modern spinal stabilization surgical techniques, avoiding late neurological deterioration.

Resumo

Introdução Apresentamos um relato de caso de fratura-luxação torácica (T11–T12) com grande deslocamento lateral entre os corpos vertebrais, sem déficit neurológico.

Objetivo Relatar o diagnóstico e tratamento de uma fratura-luxação grave na junção toracolombar com preservação da função neurológica.

Dados Fratura-luxação da coluna torácica sem déficit neurológico é uma lesão rara. Apenas 15 casos relatados na literatura foram encontrados em nossa revisão. O tratamento de escolha se faz com descompressão medular, realinhamento e estabilização.

Caso Um homem de 40 anos sofreu um acidente de bicicleta e foi admitido com dorsalgia severa, mas neurologicamente intacto. Ele foi tratado com ampla laminectomia e descompressão medular e, depois, correção da deformidade com parafusos pediculares lombares e manobras de realinhamento.

Resultados Após três dias, o paciente estava apto a caminhar, e após um mês, tinha apenas leve dorsalgia e estava neurologicamente intacto, podendo retomar suas atividades de vida diária. Após seis meses da cirurgia, mantinha-se neurologicamente estável e realizando atividades físicas regularmente.

Conclusão Fratura-luxação com deslocamento vertebral grave da coluna torácica sem déficit neurológico é uma lesão rara. Um bom desfecho pode ser obtido com técnicas modernas de estabilização da coluna e redução da lesão, evitando deterioração neurológica.

 
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