Department of Spinal Surgery and Medical Engineering, Mie University Graduate School of Medicine, Japan.
Spine (Phila Pa 1976). 2012 Oct 15;37(22):E1410-4. doi: 10.1097/BRS.0b013e318268c08a.
A case report.
To describe a case of traumatic lumbosacral spondyloptosis and present a literature review.
Traumatic spondyloptosis is a very rare injury caused by high-energy trauma. Eight cases of traumatic spondyloptosis of L5-S1 have been reported, including only 1 case treated 8.5 months after injury occurrence.
A 45-year-old Myanmar male experienced severe lower back pain and paresis of the lower extremities after a landslide disaster. Plain radiographs showed spondyloptosis, with the 5th lumbar vertebra located anterior to the 1st sacral vertebra. Computed tomography myelography demonstrated complete bilateral pars interarticularis fracture dislocation at L5-S1 and a complete block between L5 and S1 with apparent spondyloptosis. Neurological function of this patient improved after conservative treatment for 5 months; however, his severe lower back pain persisted. Thus, surgery for in situ posterior decompression and fusion of L3-S1 was performed.
Lower back pain of the patient had nearly disappeared 2 weeks after surgery, and he was able to walk for more than 1 hour without assistance 2 years after surgery.
We performed posterior decompression and in situ fusion of L3-S1 for the patients with traumatic lumbosacral spondyloptosis treated 5 months after injury, and the surgery produced a favorable clinical outcome.
研究设计：病例报告。
目的：描述一例创伤性腰骶椎滑脱病例，并进行文献复习。
背景资料概要：创伤性脊椎滑脱是一种由高能创伤引起的非常罕见的损伤。已经报道了 8 例 L5-S1 外伤性脊椎滑脱，其中仅 1 例在损伤发生后 8.5 个月进行了治疗。
方法：一名 45 岁的缅甸男性在山体滑坡灾害后出现严重的下腰痛和下肢瘫痪。X 线平片显示脊椎滑脱，第 5 腰椎位于第 1 骶椎前方。CT 脊髓造影显示 L5-S1 双侧关节突间完全骨折脱位，L5 和 S1 之间完全阻塞，明显脊椎滑脱。该患者经过 5 个月的保守治疗后神经功能有所改善，但严重的下腰痛持续存在。因此，进行了 L3-S1 后路减压和原位融合手术。
结果：术后 2 周患者的腰痛几乎消失，术后 2 年他无需辅助即可行走 1 个多小时。
结论：我们对受伤后 5 个月的创伤性腰骶椎滑脱患者进行了 L3-S1 的后路减压和原位融合，手术取得了良好的临床效果。
