Fracture-Dislocation of the Thoracic Spine without Any Neurological Deficit: A Case Report and Review of the Literature

Introduction: Thoracic spinal fracture dislocation injury usually is caused by a highenergy trauma. Therefore, this kind of injury should always be suspected in the patients who have sustained a multiple trauma. The thoracic spinal fracturedislocation is commonly accompanied by neurological symptoms. In the literature, only few cases are reported who did not present neurological symptoms. Case presentation: A 25yearold man was brought to our emergency department following a vigorous motorvehicle accident, complaining from excruciating pain in his right shoulder. The promptly obtained radiographs revealed right shoulder fracture dislocation that was reduced through intervenus sedation, in the emergency department. The overt shoulder injury distracted the ER physician rsquo;s attention from the vertebral translation, visualized in the initial chest radiographs. Secondary survey, obtained on the next day, revealed a serious T5T6 fracturedislocation and absence of neurological deficit. The computed tomography and magnetic resonance imaging provided the details of the spinal injury. Open reduction and stabilization was performed by application of the rods and pedicle screws. The neurologic condition remained intact postoperatively. A CTLSO brace was administrated to wear whenever he was walking or sitting. The brace was weaned off at the 24th week when he started physical exercises. Conclusions: In a small number of patients who suffered spinal fracturedislocation, the radiographic feature or severity does not correlate with the clinical manifestation. The treatment strategy is tailored individually, i.e., open reduction and internal fixation is advised whenever surgical intervention is indicated.