Fracture of the posterior margin of the lumbar spine: case report after an acute, unique, and severe trauma.

Abstract

Case report. We report a case of a posterior margin fracture in the lumbar spine after an acute, unique, and severe trauma with neurologic deficiency in a nonathlete adolescent with no history of lumbar pain. A literature review did not uncover a similar case. Fracture of the posterior margin of lumbar vertebral body is not a common injury. It usually occurs in adolescent and young adults and has been always reported after sports-related microtraumatisms. Symptoms are mainly back pain and radicular pain. Neurologic deficiency is rare. An acute and severe spine trauma in a nonathlete adolescent with no previous history of lumbar pain can lead to posterior vertebra margin fracture. Neurologic deficiency may appear, and it can be directly related to the posterior displacement of bone fragment or to a compressive peridural hematoma. Radiographs and computed tomograph scans are used for diagnosis. Magnetic resonance imaging is accurate to visualize disc space and for the diagnosis of peridural hematoma. Treatment is surgical and consists of laminectomy, hematoma drainage, and excision of bone fragment. Discectomy and arthrodesis are to be considered in relation to age, magnetic resonance imaging findings, and type of bone lesions.