We’ve recently seen a case of a lumbar fracture where there was no damage to the spinal canal, so the patient only felt pain—but no neurological symptoms. But what happens when one fragment is invading your spinal canal?
That’s exactly what happened in this case. Our patient slipped and felt a very intense back pain. Also, his legs felt a little weird… like a little tingling sensation… All in all, they took him to the hospital.
There, they performed a back CT. You can see an image from the CT here:
There is a fracture affecting L1 vertebra (L1 means the first lumbar, or lower back, vertebra). However, the fragments have not stayed in their place: they have displaced. One of them has moved backwards and is compressing the spinal canal, where all the nerves are running down through.
Check what his spinal canal looks like if we compare it with a normal vertebra:
If the fragment moves a little further, our patient can stop feeling his legs, moving them or even controlling his pee.
To find out how the spinal cord is doing, we performed a Spine MRI. This is the result:
These types of lesions usually require some surgery, to avoid neurological damage.
And so that’s what happened with our patient. He went to the operating room the next day and they fixed his back using some bars and screws. Even though the picture is not great, this is what it looked like afterwards:
Those screws go though the upper and lower vertebrae, fixing them and preventing them from moving any more.
The reason our patient got such a bad fracture without a powerful trauma is because there already was already a lesion in the bone, metastasis. He had kidney cancer that had spread to his vertebra, which made it weaker and prone to complex fractures.
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