5椎体に及んだ胸椎椎体分離（vertebral body separation）の1例

Five Continuous Fractures of the Thoracic Spine with Vertebral Body Separation. Case Report

　われわれは5椎体にまで及んだ胸腰椎損傷AO分類における胸椎C1.2.4 vertebral body separationの稀な1例を報告する．症例は27歳の男性でバイク事故により受傷した．X線とCT像で，Th5～9まで椎体から椎弓根にかけての骨折を認めていたが，神経症状は認めなかった．Th3～10までの後方固定術を施行し早期の離床を可能にした．AO分類では受傷機転によって詳細に分類されているが，この骨折は胸椎の解剖学的特徴と受傷機転から脊髄損傷を伴うことは稀である．よって早期離床のためには手術療法が望ましいと思われた．

　We report a rare case of 5 continuous fractures of the thoracic spine with no spinal cord injury.　The patient was a 27-year-old man who was injured in a traffic accident.　Based on the CT scan findings, he was diagnosed with in multiple fractures involving both the vertebral body and pedicle of T5 through T9 in of the thoracic spine.　However, the patient was free of neurological symptoms.　We chose to treat the patient surgically and performed a long posterior spinal fusion involving the T3 through T10 levels.　As a result of the surgical stabilization, the patient was able to stand and walk in the early postoperative period.　The fracture was classified as a C.1.2.4, vertebral body separation based on the AO thoracic and lumbar spine injuries classification.　Because of the anatomical characteristics of thoracic spine and the mechanism of the injury this type of fracture is rarely associated with cord injury.　We recommend that this type of fracture was treated surgically to enable early recovery of the patient.