Abstract
Introduction
In fracture dislocations of the lumbar region, two anatomical facts can help patients preserve neurological damage in comparison less trauma to the cervical or thoracic region. First place in adults, the spinal cord extends only to the level of the lower border of the first lumbar vertebra, second, the vertebral hole large in this region gives ample space to the roots of the cauda equina, so both nerve injury may be minimal in this region because in this area are housed nerve roots with great space, less content, and more continent.
Patients and Methods
We present the case of a 48-year-old male, construction worker, who suffered a fall from a height of approximately 15 m beating directly on the lumbar region against a beam, presenting pain and inability to move the legs, brought to the emergency room 1 hour after the accident, is assessed clinically, X-rays and CT scan are taken, and diagnosed as L3–L4 fracture dislocation with ASIA B. The patient was surgically intervened 3 hours after the accident with reduction via posterior transpedicular fixation. One week later anterior approach was performed with intersomatic vertebral cage.
Results
The patient progressed to ASIA C 24 hours after the first surgery. Three months later, he became a functional patient with ASIA D and control of sphincters.
Conclusion
The author's purpose is to show the results obtained by an intervention in the early hours of the trauma which helped promote a nonfunctional injury to a functional lesion, and almost total recovery.