Tollefson Lauren J, Cho John Chin-Suk
Clinical Sciences Department, Parker University, Dallas, Texas.
J Chiropr Med. 2019 Jun;18(2):139-143. doi: 10.1016/j.jcm.2018.12.002. Epub 2019 Jun 26.
The purpose of this case study is to describe the diagnostic imaging studies of a patient who had a traumatic spondylolisthesis at L5-S1 secondary to unilateral facet fractures.
A 21-year-old man experienced a rollover motor vehicle crash that led to low back pain and progressive left-sided radiculopathy. Later, he sought treatment from a doctor of chiropractic because he continued to have low back pain with progressive pain down his left leg. A magnetic resonance imaging study demonstrated a left paracentral disc protrusion at L5-S1. Follow-up computed tomography demonstrated multiple transverse process fractures and left-sided L5-S1 facet fractures with spondylolisthesis that progressed over time.
The patient was referred for a neurosurgical consultation 10 months after the injury. At 12 months after the injury, he underwent transforaminal lumbar interbody fusion with a posterior approach. The patient's pain and radicular symptoms resolved after the surgery.
This patient exhibited posterior element fractures, had continued symptom progression, and was monitored for the development of a spondylolisthesis. Because of progression and exacerbation of symptoms, neurosurgical consultation for surgical stabilization was mandated.
本病例研究的目的是描述一名因单侧小关节骨折继发L5 - S1创伤性椎体滑脱患者的诊断性影像学检查。
一名21岁男性经历了翻车机动车碰撞事故，导致下背部疼痛和进行性左侧神经根病。后来，他因持续下背部疼痛且左腿疼痛逐渐加重而寻求整脊医生治疗。磁共振成像研究显示L5 - S1左侧旁中央椎间盘突出。后续计算机断层扫描显示多处横突骨折以及左侧L5 - S1小关节骨折伴椎体滑脱，且随着时间推移病情进展。
患者在受伤10个月后被转诊进行神经外科会诊。受伤12个月后，他接受了后路经椎间孔腰椎椎间融合术。术后患者的疼痛和神经根症状得到缓解。
该患者表现出后部结构骨折，症状持续进展，并对椎体滑脱的发展进行了监测。由于症状进展和加重，必须进行神经外科会诊以进行手术稳定治疗。
