Severe old lumbar fracture and dislocation with cauda equina nerve transection: A case report
Yuancheng Zhang1*
, Libo Feng1*, Jun Ao2, Yang Zeng3, Wuyin Zhou4, Kaijun Fu1, Jian Li1, Xiying Zhang5
1Department of Orthopaedics, Jinsha County People’s Hospital, Bijie, China
2Department of Spinal Surgery, The First Affiliated Hospital of Zunyi Medical University, Zunyi, China
3 Department of Neurosurgery, Jinsha County People’s Hospital, Bijie, China
4Department of Urology, Jinsha County People’s Hospital, Bijie, China
5Department of Endocrinology, Jinsha County People’s Hospital, Bijie, China
Keywords: Cauda equina nerve transection, dislocation, lumbar fracture, surgical intervention.
Abstract
Severe old lumbar fractures and dislocations with associated cauda equina nerve transection are rare clinical presentations which pose significant management challenges. This case report highlights a unique instance of such an injury, emphasizing novel surgical strategies for reconstruction and recovery. A 30-year-old male patient was admitted after sustaining a severe open fracture and degree IV posterior dislocation of L3 vertebra, accompanied by cauda equina nerve transection, spinal cord injury and multiple organ injuries. Following initial stabilization, the patient underwent surgical reduction and internal fixation two months after the injury. The procedure involved cauda equina nerve reconstruction using sural nerve grafts. Postoperatively, the patient showed improved bladder function and regained some mobility. However, he later developed arachnoiditis ossificans of the cauda equina, resulting in severe pain, which required additional surgical intervention. In conclusion, this case underscores the importance of timely intervention in severe thoracolumbar injuries and presents a successful approach to nerve reconstruction.
Citation: Zhang Y, Fen L, Ao J, Zeng Y, Zhou W, Fu M, et al. Severe old lumbar fracture and dislocation with cauda equina nerve transection: A case report. Jt Dis Relat Surg 2025;36(2):437-443. doi: 10.52312/jdrs.2025.2059.
Managed patient care, collected imaging data, conducted follow-up evaluations, and drafted the manuscript: Y.Z.; Organized imaging materials, identified key radiological features, and co-wrote the manuscript: L.F.; Designed the S-rod reduction technique and performed internal fixation: J.A.; Analyzed cauda equina repair strategies and technical innovations: Y.Z.; Wrote the ossifying arachnoiditis discussion section: W.Z.; Validated clinical data accuracy: K.F., J.L.; Supervised the study, finalized data verification, revised the manuscript, and handled submission: X.Z.
The authors declared no conflicts of interest with respect to the authorship and/or publication of this article.
The authors received no financial support for the research and/or authorship of this article.
The data that support the findings of this study are available from the corresponding author upon reasonable request.