- Department of Neurosurgery, Liaquat National Institute of Postgraduate Studies, Karachi, Pakistan
- Department of Radiology, Liaquat National Hospital and Medical College, Karachi, Pakistan.
Correspondence Address:
Fawwaz Bin Shahab, Department of Neurosurgery, Liaquat National Institute of Postgraduate Studies, Karachi, Pakistan.
DOI:10.25259/SNI_1077_2022
Copyright: © 2023 Surgical Neurology International This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, transform, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.How to cite this article: Fawwaz Bin Shahab1, Amna Ghouri1, Manzar Hussain1, Sadaf Nasir2. Traumatic L5/S1 bilateral locked facets with bilateral pars fractures – A case report. 08-Jun-2023;14:200
How to cite this URL: Fawwaz Bin Shahab1, Amna Ghouri1, Manzar Hussain1, Sadaf Nasir2. Traumatic L5/S1 bilateral locked facets with bilateral pars fractures – A case report. 08-Jun-2023;14:200. Available from: https://surgicalneurologyint.com/surgicalint-articles/12355/
Abstract
Background: Although rare, traumatic lumbosacral (L/S) Grade I spondylolisthesis (i.e., Lumbar locked facet syndrome) is characterized by unilateral or bilateral facet dislocations.
Case Description: A 25-year-old male presented following a high velocity road traffic accident with back pain and tenderness at the L/S junction. His radiologic images showed bilateral locked facets at the L5/S1 level with Grade 1 spondylolisthesis, bilateral pars fractures, acute traumatic L5/S1 disc herniation, and disruption of the anterior and posterior longitudinal ligaments. After undergoing a L4-S1 laminectomy with pedicle screw fixation, he became asymptomatic and remained neurologically stable.
Conclusion: L5/S1 facet dislocation whether unilateral or bilateral needs to be diagnosed early and treated with realignment and instrumented stabilization.
Keywords: L5-S1, Lumbosacral (LS), Pars fracture, Road traffic accident (RTA), Traumatic lumbar locked facet
INTRODUCTION
Traumatic L5S1 unilateral or bilateral facet dislocations with resultant Grade I spondylolisthesis need to be recognized early and appropriately decompressed and stabilized.[
CASE REPORT
Following a high velocity traffic accident, a 25-year-old male presented with back pain and tenderness at lumbosacral (L/S) junction but remained neurologically intact. The computed tomography (CT) scan showed bilateral locked facets at the L5/S1 level with Grade 1 spondylolisthesis, bilateral pars fractures, L5/S1 herniated disc, and disruption of the anterior/ posterior longitudinal ligament [
DISCUSSION
Fracture dislocations of the L/S spine are rare, with L5/S1 involvement being even less reported than L4/L5.[
As bilateral facet dislocations result in an unstable 3-column injury, they need to be quickly reduced, decompressed, and fused to avoid the progression or the onset of new neurological dysfunction.[
CONCLUSION
Traumatic bilateral facet fractures/dislocations, Grade I spondylolisthesis, and disc herniations at the L5S1 level, documented with X-rays and CT studies, should be decompressed and stabilized early in the clinical course to avoid the onset of new or the progression of neurologic deficits.[
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
Disclaimer
The views and opinions expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Journal or its management. The information contained in this article should not be considered to be medical advice; patients should consult their own physicians for advice as to their specific medical needs.
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