Beguiristain J, Schweitzer D, Mora G, Pombo V
Department of Orthopaedic Surgery, School of Medicine, University of Navarra, Pamplona, Spain.
Spine (Phila Pa 1976). 1995 Feb 1;20(3):362-6. doi: 10.1097/00007632-199502000-00020.
The authors present an unusual case of pure traumatic bilateral lumbosacral dislocation in a 5-year-old boy, the conservative treatment carried out, and the long-term result.
To describe a rare traumatic lesion in children and evaluate the result obtained with conservative treatment.
Watson-Jones was the first to describe this type of lesion. Since then, only a few cases have been added. Most authors suggest that open reduction should be carried out. No cases of this type of injury in children have been reported.
A 5-year-old boy was hit in the lumbosacral region with a rocking chair. Examination showed neurologic deficit of left L5 and S1 nerve roots. Roentgenographic examination and computed tomography scan confirmed the anterior dislocation of the fifth lumbar vertebra on the sacrum without any fracture. He was treated with traction, followed by hyperextension in a Cotrel traction table and further immobilization with a lumbar plaster jacket.
Eight years after the injury, the patient had no neurologic deficit and lumbar radiographs showed a good alignment of the lumbosacral spine.
In children with traumatic lumbosacral dislocation, closed reduction should be attempted even if neurologic deficit is present.
作者报告了一例5岁男孩单纯创伤性双侧腰骶椎脱位的罕见病例、所采取的保守治疗方法及长期结果。
描述一种儿童罕见的创伤性损伤，并评估保守治疗的效果。
沃森-琼斯是首个描述此类损伤的人。自那时起，仅有少数病例被补充报道。大多数作者建议进行切开复位。儿童中此类损伤的病例此前未见报道。
一名5岁男孩被摇椅撞击腰骶部。检查显示左侧L5和S1神经根神经功能缺损。X线检查及计算机断层扫描证实第五腰椎相对于骶骨向前脱位，无任何骨折。对其进行牵引治疗，随后在Cotrel牵引床上进行过伸牵引，并使用腰部石膏背心进一步固定。
受伤8年后，患者无神经功能缺损，腰椎X线片显示腰骶椎排列良好。
对于创伤性腰骶椎脱位的儿童，即使存在神经功能缺损，也应尝试闭合复位。
