UNUSUAL BURST FRACTURE IN AN ADOLESCENT INVOLVING THE APOPHYSEAL PLATE

A 12-year-old girl sustained an unusual bursttype fracture of her firs t lumbar vertebrae. The main fracture occurred through the anterior ri ng apophyses and the pedicle-body junction. The anterior ring apophyse s were left close to their anatomic position. However, the whole verte bral body with minor internal fracturing was retropulsed into the spin al canal, resulting in incomplete paraplegia. Initial radiographs were complicated by a fracture-dislocation. However, a computed tomography scan elucidated the above-stated fracture pattern. This pattern has n ot been previously reported to our knowledge. Treatment consisted of i ntravenous steroids, anterior decompression, anterior fusion with inst rumentation, and postoperative thoracolumbar-sacral orthosis. Neurolog ic improvement has occurred. The patient can now walk independently, b ut still has absent bladder/bowel function 3 months postoperatively.