Triangular Osteosynthesis as a Treatment of Lumbopelvic Dissociation with Acute Cauda Equina Syndrome in an 11-Year-Old Patient

J Am Acad Orthop Surg Glob Res Rev. 2023 Nov 15;7(11):e23.00090. doi: 10.5435/JAAOSGlobal-D-23-00090. eCollection 2023 Nov 1.

Abstract

This case offers a safe and effective method for treating lumbopelvic dissociation in a pediatric patient with cauda equina syndrome using a triangular osteosynthesis construct. After a high-speed accident, an 11-year-old girl was admitted to the hospital with bowel and bladder incontinence and bilateral lower extremity weakness. The orthopaedic trauma and spine teams elected for surgical treatment with a triangular osteosynthesis construct, a procedure usually reserved for adults. The surgery was uncomplicated, and the patient experienced complete resolution of her preoperative symptoms. She is doing well over 1-year postoperatively, with full neurologic recovery, maintained reduction, bony healing, and subsequent implant removal. To our knowledge, this is the youngest reported case of lumbopelvic dissociation treated in this manner and represents a viable treatment option.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Cauda Equina Syndrome* / complications
  • Cauda Equina Syndrome* / surgery
  • Child
  • Decompression, Surgical / adverse effects
  • Decompression, Surgical / methods
  • Female
  • Fracture Fixation, Internal / adverse effects
  • Humans
  • Polyradiculopathy* / diagnosis
  • Polyradiculopathy* / etiology
  • Polyradiculopathy* / surgery
  • Spine / surgery