Unusual 2-Stages Posterior Approach Surgical Treatment for Complete Fracture Dislocation

Purpose: Traumatic posterior dislocation of the upper thoracic spine without neurological deficit has rarely been reported previously in the literature and most surgeons have less experience for surgical treatment for this kind of injury. We described a case of complete posterior dislocation of the T3 thoracic spine without neurological deficit, and its management with pedicle screw fixation and reduction through an posterior approach. Methods: A 23-years-old man was threw out of the coach when the traffic accident happened on a highway. Clinical and imaging findings of the patient were described. Surgical treatment with posterior decompressive laminectomy, trans-pedicle screw fixation, and reduction was performed by the authors. We also reviewed the relevant literature. Results: Complete reduction was achieved without neurological sequelae. To our knowledge, several similar cases reported in the literature were severe fracturedislocation below T4, and few case with upper thoracic spine without neurological deficit was reported previously. Conclusions: Our experience proves that the unusual 2-stages posterior approach is a good choice for treating severe upper thoracic dislocation in acute phase. Therefore, the presented technique is an alternative approach for this rare injury.