PMC4732254_01
Sagittal (a) and coronal (b) reformatted and axial images (c) from a contrast-enhanced computed tomography, showing grade III spondylolisthesis of L2 over L3 (arrows) with inferior endplate fracture of L2 (arrowhead)
AJNS-11-72a-g001.jpg
PMC4732254_01_AJNS-11-72a-g001.jpg
F1
It revealed transverse fracture through L2 vertebral body with grade III spondylolisthesis of L2 over L3 causing severe neural canal compromise [Figure 1]. Patient also had aortic dissection at the isthmus with traumatic aneurysm formation, mediastinal hematoma, and right mild hemothorax [Figure 1].
Sagittal T1-weighted (a) and T2-weighted (b) magnetic resonance images showing anterolisthesis of L2 over L3 with associated extensive anterior and posterior ligament disruption. The spinal cord is clearly seen to be transected at D11 vertebral level (arrow) with clumped up and thickened distal segment noted from L1 vertebral level (arrowhead). Upper dorsal spine shows distortion artifacts due to aortic stent-graft
AJNS-11-72a-g002.jpg
PMC4732254_01_AJNS-11-72a-g002.jpg
F2
The distal cord segment was noted to be lying clumped up inferiorly at L2-L3 level with severe compression and stretching across the site of spondylolisthesis [Figures 2 and 3].
Serial axial T2-weighted images of the spine in a craniocaudal direction from the normal proximal cord to distal cauda equina. It is showing normal proximal dorsal cord (a) which is then disappearing at the level of transection with empty thecal sac (b). Distally the pulled down cord reappears (c) and can be seen traversing horizontally at L2-L3 level (d). Conus medullaris is lying at L3 (e) with cauda equina (f) distal to it
AJNS-11-72a-g003.jpg
PMC4732254_01_AJNS-11-72a-g003.jpg
F3
The distal cord segment was noted to be lying clumped up inferiorly at L2-L3 level with severe compression and stretching across the site of spondylolisthesis [Figures 2 and 3].
Posttreatment radiograph showing spinal fixation prosthesis with pedicle screws. Note also the stent graft in proximal descending aorta
AJNS-11-72a-g004.jpg
PMC4732254_01_AJNS-11-72a-g004.jpg
F4
Aortic injury was managed by endovascular stent-graft [Figure 4].