This is a female patient who fell from a 2nd floor balcony. She presented with bilateral lower limb paraesthesia.
A CT scan was performed and showed a fracture-dislocation centred on L4 vertebra, with marked loss of height of the entire vertebral body (click image for lateral film), and retrolisthesis of L3 on L4, and L4 on L5. Retropulsed bone fragments severely narrow the spinal canal.
Afterwards the patient underwent surgery to reduce the marked vertebral compression and stabilise the spine.
After six months the patient has not managed to recover from this injury and she may never be able to walk again. She is undergoing physiotherapy / rehabilitation.
Fracture-dislocations have the highest incidence of neurological deficit. Patients who are neurologically intact should be surgically stabilized to prevent neurological injury and to permit early patient mobilization. Patients with complete neurological injuries should also be surgically stabilized to hasten rehabilitation.
Reference: Eskenazi, Mark S. Bendo, John A. Spivak, Jeffrey M. Thoracolumbar spine trauma: evaluation and management. Current Opinion in Orthopaedics. 11(3):176-185, June 2000.Credit: Fernando Leite