Surgically treated Chance fracture of L1

Case contributed by Dr Chris O'Donnell

Presentation

Involved in high speed motor vehicle accident (seatbelt applied). Chance fracture of L1 treated with metallic stabilization procedure

Patient Data

Age: 20
Gender: Male

Pre-operative scan at time of injury

Modality: CT

Typical hyperflexion Chance fracture of L1 with compression of the vertberal body and horizontal fractures traversing the pedicles, transverse processes and spinous process with a gap in the spinous process fracture fragments.

CT scan at 1 month following surgical procedure

Modality: CT

Following reduction of the fractures and insertion of bipedicular screws at T12 (above) and L2 (below) the fracture sites, alignment is now almost anatomical

Case Discussion

Given that all 3 spinal "columns" (Denis) are disruptured, this is a highly unstable injury that is surgically treated to prevent progressive kyphosis.  Treatment is by metallic stabilization (above and below) in extension after fracture reduction.

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Case Information

rID: 41725
Case created: 16th Dec 2015
Last edited: 16th Dec 2015
Inclusion in quiz mode: Included

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