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Landmine Injury Resulting in Comminuted Lumbar Facet Fracture as a Cause of Lumbar Stenosis and Spondylolisthesis

Authors :
Chen, Jason A
Mooney, Michael A
Rachlin, Jacob R
Source :
Military Medicine; March 2024, Vol. 189 Issue: 3-4 pe902-e906, 5p
Publication Year :
2024

Abstract

Lumbar facet fractures are rarely reported and have been linked to sports and spine surgery. We describe the case of a 77-year-old patient who sustained an injury from multiple landmine blasts during the Vietnam War. He had low back pain since that time, which was initially managed conservatively. However, the pain progressed over decades to severe neurogenic claudication that greatly restricted his quality of life. Neuroimaging revealed the presence of bone fragments impinging on the spinal canal at the L5/6 level (transitional anatomy) that resulted from a comminuted fracture of the lumbar facet at the inferior articular process. We performed an L5/6 decompressive laminectomy, with removal of these fragments, and posterior instrumented fusion, with substantial improvement in symptoms. This case illustrates a unique mechanism of lumbar facet fracture and the biomechanic origination, natural history, and optimal treatment of this entity. We expand on the spectrum of lumbosacral injuries associated with the combat blast injury that have only increased in prevalence in recent conflicts.

Details

Language :
English
ISSN :
00264075 and 1930613X
Volume :
189
Issue :
3-4
Database :
Supplemental Index
Journal :
Military Medicine
Publication Type :
Periodical
Accession number :
ejs65591963
Full Text :
https://doi.org/10.1093/milmed/usad358