Rationale: Traumatic nucleus pulposus sequestration (TNPS) usually occurs concurrently with severe destruction of bone. TNPS combined with a slight thoracolumbar flexion-distraction fracture, triggering a disastrous nerve injury, has rarely been reported. Due to the atypical radiologic manifestations, such a patient can easily be overlooked. Patient concerns: Hereby, we present a TNPS patient as well as a slight thoracolumbar flexion-distraction fracture and serious neurologic symptoms. Diagnoses: T12 spinous process fracture, L1 flexion distraction fracture, thoracolumbar traumatic nucleus pulposuse sequestration and lower limbs incomplete paralysis Interventions: To avoid further neurologic compromise, an urgent laminectomy and exploration of the spinal canal was performed. Outcomes: After decompression OR and 4 months rehabilitation, the patient's neurologic function improved remarkably. Lessons: A slight flexion-distraction fracture following injury is liable to eclipse the concurrence of TPNS. For this patient, a high-resolution MRI was needed to make a definitive diagnosis and guide surgery. Once TPNS has been diagnosed, sufficient decompression and discectomy surgery should be performed without delay.
[1]Jilin Univ, China Japan Union Hosp, Orthopaed Surg Dept, Jilin, Jilin, Peoples R China.
[2]Jilin Univ, Bethune Hosp 1, Radiotherapy Dept, Jilin, Jilin, Peoples R China.
[3]Jilin Univ, China Japan Union Hosp, Pathol Dept, Jilin, Jilin, Peoples R China.
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