Kimura Ryota, Ono Yuichi, Miyakoshi Naohisa
Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, JPN.
Cureus. 2025 May 18;17(5):e84366. doi: 10.7759/cureus.84366. eCollection 2025 May.
Flexion-distraction injuries of the thoracolumbar spine, often classified as AO type B2, are typically considered unstable and are generally managed surgically. However, the optimal approach for managing such injuries in elite athletes remains unclear, particularly considering the potential career-limiting consequences of spinal fusion. We report the case of a 32-year-old professional soccer player who sustained a flexion-distraction injury at the T12-L1 level during a match. Imaging confirmed an L1 compression fracture with posterior ligament complex disruption. Despite surgical indications, the athlete exhibited excellent core stability, no neurological deficits, and preserved alignment. A multidisciplinary team opted for conservative treatment, including rigid bracing and staged rehabilitation. The athlete resumed non-contact training at week seven, returned to full-contact practice at week 10, and competed in official matches by week 12. At the two-year follow-up, he remained symptom-free, with no spinal deformity or recurrence. This case suggests that in elite athletes with preserved spinal stability and core strength, conservative management of flexion-distraction injuries may allow for a timely return to play while avoiding the long-term drawbacks of fusion surgery. Individualized decision-making and close follow-ups are essential.
胸腰椎的屈曲-牵张损伤，通常归类为AO B2型，一般被认为是不稳定的，通常需手术治疗。然而，对于精英运动员此类损伤的最佳治疗方法仍不明确，尤其是考虑到脊柱融合可能带来的限制职业生涯的后果。我们报告了一名32岁职业足球运动员的病例，他在一场比赛中T12-L1水平发生了屈曲-牵张损伤。影像学检查证实L1压缩性骨折伴后韧带复合体断裂。尽管有手术指征，但该运动员表现出良好的核心稳定性，无神经功能缺损，且脊柱对线良好。一个多学科团队选择了保守治疗，包括使用刚性支具和分阶段康复。该运动员在第7周恢复了非接触性训练，第10周恢复了全接触训练，并在第12周参加了正式比赛。在两年的随访中，他无症状，无脊柱畸形或复发。该病例表明，对于脊柱稳定性和核心力量良好的精英运动员，屈曲-牵张损伤的保守治疗可能使他们能够及时重返赛场，同时避免融合手术的长期弊端。个体化决策和密切随访至关重要。
