Severe old lumbar fracture and dislocation with cauda equina nerve transection: A case report

Severe old lumbar fractures and dislocations with associated cauda equina nerve transection are rare clinical presentations which pose significant management challenges. This case report highlights a unique instance of such an injury, emphasizing novel surgical strategies for reconstruction and recovery. A 30-year-old male patient was admitted after sustaining a severe open fracture and degree IV posterior dislocation of L3 vertebra, accompanied by cauda equina nerve transection, spinal cord injury and multiple organ injuries. Following initial stabilization, the patient underwent surgical reduction and internal fixation two months after the injury. The procedure involved cauda equina nerve reconstruction using sural nerve grafts. Postoperatively, the patient showed improved bladder function and regained some mobility. However, he later developed arachnoiditis ossificans of the cauda equina, resulting in severe pain, which required additional surgical intervention. In conclusion, this case underscores the importance of timely intervention in severe thoracolumbar injuries and presents a successful approach to nerve reconstruction.

Declarations

Author Contributions

Managed patient care, collected imaging data, conducted follow-up evaluations, and drafted the manuscript: Y.Z.; Organized imaging materials, identified key radiological features, and co-wrote the manuscript: L.F.; Designed the S-rod reduction technique and performed internal fixation: J.A.; Analyzed cauda equina repair strategies and technical innovations: Y.Z.; Wrote the ossifying arachnoiditis discussion section: W.Z.; Validated clinical data accuracy: K.F., J.L.; Supervised the study, finalized data verification, revised the manuscript, and handled submission: X.Z.

Conflict of Interest

The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.

Financial Disclosure

The authors received no financial support for the research and/or authorship of this article.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author upon reasonable request.