Traumatic Disc Herniation Following Flexion-Distraction Injury of the Thoracolumbar Spine: A Rare Presentation

Abstract

Objective: To report a rare presentation of Flexion-distraction injuries. Summary of background data: To the best of our knowledge, traumatic disc herniation following non translated flexion distraction injuries of the thoracolumbar spine has not been reported in the English literature. Methods: Description of the clinic and radiological presentation of a 35-year-old male who sustained a flexion distraction injury of the thoracolumbar spine following an assault. Results: The intraoperative findings confirmed the presence of a large herniated disc fragment displacing the thecal sac. This was removed, the canal was decompressed and a hybrid screw-laminar hook construct was used to stabilize the fractured level while preserving uninjured motion segments. Conclusions: MRI provides useful information to help define the pathology and management strategies in patients with discordance between their clinical presentation and imaging. It helped define a rare presentation of disc herniation and alerted us to the need for a formal decompression in this case of a non-translated flexion-distraction injury.