Yin Ruofeng, Chang Pengyu, Zhu Qingsan, Cheng Fei, Zhao Baolin, Gu Rui, Zhang Bo-Yin
Orthopaedics Surgery Department, China-Japan Union Hospital of Jilin University Radiotherapy Department, First Bethune Hospital of Jilin University Pathology Department, China-Japan Union Hospital of Jilin University, Jilin Province, China.
Medicine (Baltimore). 2018 Jun;97(25):e10952. doi: 10.1097/MD.0000000000010952.
Traumatic nucleus pulposus sequestration (TNPS) usually occurs concurrently with severe destruction of bone. TNPS combined with a slight thoracolumbar flexion- distraction fracture, triggering a disastrous nerve injury, has rarely been reported. Due to the atypical radiologic manifestations, such a patient can easily be overlooked.
Hereby, we present a TNPS patient as well as a slight thoracolumbar flexion-distraction fracture and serious neurologic symptoms.
T12 spinous process fracture, L1 flexion distraction fracture, thoracolumbar traumatic nucleus pulposuse sequestration and lower limbs incomplete paralysis INTERVENTIONS:: To avoid further neurologic compromise, an urgent laminectomy and exploration of the spinal canal was performed.
After decompression OR and 4 months rehabilitation, the patient's neurologic function improved remarkably.
A slight flexion-distraction fracture following injury is liable to eclipse the concurrence of TPNS. For this patient, a high-resolution MRI was needed to make a definitive diagnosis and guide surgery. Once TPNS has been diagnosed, sufficient decompression and discectomy surgery should be performed without delay.
创伤性髓核游离（TNPS）通常与严重的骨质破坏同时发生。TNPS合并轻微的胸腰椎屈曲-牵张性骨折并引发灾难性神经损伤的情况鲜有报道。由于影像学表现不典型，此类患者很容易被忽视。
在此，我们报告一例TNPS患者，同时伴有轻微的胸腰椎屈曲-牵张性骨折及严重的神经症状。
T12棘突骨折、L1屈曲牵张性骨折、胸腰椎创伤性髓核游离及下肢不完全瘫痪
为避免神经功能进一步受损，紧急实施了椎板切除术并探查椎管。
减压手术后经4个月康复治疗，患者神经功能显著改善。
损伤后轻微的屈曲-牵张性骨折容易掩盖TNPS的并存情况。对于该患者，需要高分辨率MRI来明确诊断并指导手术。一旦诊断为TNPS，应立即进行充分的减压和椎间盘切除术。
