Chance fracture

Case contributed by Ryan Thibodeau
Diagnosis certain


Unable to move bilateral lower extremities following skiing accident.

Patient Data

Age: 20 years
Gender: Male

There is an acute, comminuted fracture through the L3 vertebral body which involves the right pedicle, left superior articulating facet, left lamina and extends through the spinous process. Associated bony retropulsion from the vertebral body results in severe spinal canal stenosis. There are acute minimally displaced fractures involving the L2 and L3 spinous processes. There are acute minimally displaced fractures involving the left L2, L3 and L4 transverse processes. There is a nondisplaced fracture through the right sacral ala.

Case Discussion

This is a case of a Chance fracture (fracture involving all three spinal columns).

The patient underwent an L2-L4 decompression and instrumentation procedure. The sacral ala fracture was treated conservatively. He was discharged to acute rehabilitation 4 days following the accident.

Michael Cooley, MD
Christine Cooley, MD

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