Presentation
Presents after being hit by a car today. Recumbent and non-ambulatory. Deep pain absent in both pelvic limbs.
Patient Data
There is a comminuted, oblique fracture of the body of L3. The vertebra is compressed and shortened due to the fracture. The facet joint is luxated, and the floor of the vertebral canal of L3 is at the level of the roof of the canal at L4. There is also a cleft in the cranial vertebral endplate of T9 without evidence of displacement.
Vertebral fracture.
Case Discussion
There is a comminuted fracture of the L3 vertebra as well as a luxation of L3-L4. This instability resulted in severe spinal myelomalacia that was found at post mortem. A second incomplete fracture was found in the T8-T9 region, and a spinal cord compression at T12 whose origin was not described.
It is contraindicated to take an orthagonal projection in an unstable spine because of the risk of further spinal cord trauma, however a CT could be performed in lateral recumbency to obtain more detailed imaging information.
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