Double Level Extension-Distraction Thoracic Spine Injuries with Concomitant Double Level Sternal Fractures:A Case Report

Extension-distraction injuries caused by hyperextension of the spine typically occur in the cervical region, as seen in “whiplash” injuries. This type of injury is rare in the thoracolumbar spine, comprising less than 3% of fractures in this region . Denis and Burkus described it as “lumberjack paraplegia” as most patients with this injury were struck in the back by a falling tree . Rare instances of traumatic thoracolumbar extension-distraction injuries have been described in adults with rigid spines resulting from diffuse idiopathic skeletal hyperostosis (DISH) and ankylosing spondylitis as these conditions predispose the adjacent level to fracture due to acute transition in the stiffness of the spine. In the majority of cases, extension distraction injuries occur at an isolated (single) level. This case report describes a rare two level extension-distraction thoracic spine injury in an otherwise healthy adult resulting from a motor vehicle accident.