L M Veras del Monte1, J Bagó. 1. Department of Orthopedic Surgery, Vall d'Hebron's University Hospital of Barcelona, Spain. luima@codetel.net.do
Abstract
STUDY DESIGN: Case report of a patient with lumbosacral dislocation. OBJECTIVES: To report a case of traumatic lumbosacral dislocation treated nonoperatively, with 10 years of follow-up. SUMMARY OF BACKGROUND DATA: Lumbosacral dislocation is rare, with only 48 cases reported in the literature. Surgical treatment by means of open reduction and fusion is advisable. However, the literature shows six cases of patients with complete lumbosacral dislocation treated nonoperatively with good results. METHODS: A 38-year-old man was involved in a highspeed vehicle accident. The lumbosacral dislocation (anterior displacement of L5 on S1, 44% slippage) was initially missed, and the patient was treated conservatively. RESULTS: Slippage did not progress, and the patient returned to full, normal activity. Ten years later he is asymptomatic and is able to work and play sports. CONCLUSIONS: This study reports a rare injury of the lumbosacral junction that was detected 3 months after injury. Satisfactory results were obtained with nonoperative treatment in this case. Although a surgical approach is advisable in acute cases to decompress the neurologic structures and to stabilize the lumbosacral junction, conservative management may be the treatment of choice in inveterate lesions.
STUDY DESIGN: Case report of a patient with lumbosacral dislocation. OBJECTIVES: To report a case of traumatic lumbosacral dislocation treated nonoperatively, with 10 years of follow-up. SUMMARY OF BACKGROUND DATA: Lumbosacral dislocation is rare, with only 48 cases reported in the literature. Surgical treatment by means of open reduction and fusion is advisable. However, the literature shows six cases of patients with complete lumbosacral dislocation treated nonoperatively with good results. METHODS: A 38-year-old man was involved in a highspeed vehicle accident. The lumbosacral dislocation (anterior displacement of L5 on S1, 44% slippage) was initially missed, and the patient was treated conservatively. RESULTS: Slippage did not progress, and the patient returned to full, normal activity. Ten years later he is asymptomatic and is able to work and play sports. CONCLUSIONS: This study reports a rare injury of the lumbosacral junction that was detected 3 months after injury. Satisfactory results were obtained with nonoperative treatment in this case. Although a surgical approach is advisable in acute cases to decompress the neurologic structures and to stabilize the lumbosacral junction, conservative management may be the treatment of choice in inveterate lesions.