Missed T8-T9 translational fracture with intact neurology: A Case report

Translational fracture of the thoracic spine, though rare due to its stability, is often associated with spinal cord injury and neurological deficits. Few cases present with intact neurology. We report a case of a 28-year-old woman who, after a road traffic accident, had persistent back pain with i...

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Main Authors: Niraj Kumar Sharma, Rishi Ram Banjade, Sabin Pokharel, Sharmila Ghimire
Format: Article
Language:English
Published: Nepal Medical Association 2025-06-01
Series:Journal of Nepal Medical Association
Subjects:
Online Access:https://www.jnma.com.np/jnma/index.php/jnma/article/view/9126
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author Niraj Kumar Sharma
Rishi Ram Banjade
Sabin Pokharel
Sharmila Ghimire
author_facet Niraj Kumar Sharma
Rishi Ram Banjade
Sabin Pokharel
Sharmila Ghimire
author_sort Niraj Kumar Sharma
collection DOAJ
description Translational fracture of the thoracic spine, though rare due to its stability, is often associated with spinal cord injury and neurological deficits. Few cases present with intact neurology. We report a case of a 28-year-old woman who, after a road traffic accident, had persistent back pain with intact neurology. The initial chest radiograph showed a subtle deformity that was missed, likely because a lateral view was not done, and the patient was discharged. Persistent back pain led to CT imaging, revealing a T8–T9 translational fracture, left 4th and 5th posterior rib fractures near the costovertebral junction, and a T7 transverse process fracture. MRI confirmed these findings. She underwent posterior instrumentation and decompression, with symptom relief, and remained asymptomatic on follow-up. Translational thoracic spine fractures, typically associated with neurological deficits, can be missed when neurology is intact. Timely imaging and intervention are crucial for optimal outcomes.
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spelling doaj-art-8ee869a6887a4f7ba04a9ff704ba34ff2025-08-20T03:28:22ZengNepal Medical AssociationJournal of Nepal Medical Association0028-27151815-672X2025-06-016328710.31729/jnma.9126Missed T8-T9 translational fracture with intact neurology: A Case reportNiraj Kumar Sharma0Rishi Ram Banjade1Sabin Pokharel2Sharmila Ghimire3Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu,NepalKathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu, NepalNational Trauma Centre,Mahankal,Kathmandu ,Nepal.Kathmandu Medical College and Teaching Hospital, Sinamangal, Kathmandu,Nepal Translational fracture of the thoracic spine, though rare due to its stability, is often associated with spinal cord injury and neurological deficits. Few cases present with intact neurology. We report a case of a 28-year-old woman who, after a road traffic accident, had persistent back pain with intact neurology. The initial chest radiograph showed a subtle deformity that was missed, likely because a lateral view was not done, and the patient was discharged. Persistent back pain led to CT imaging, revealing a T8–T9 translational fracture, left 4th and 5th posterior rib fractures near the costovertebral junction, and a T7 transverse process fracture. MRI confirmed these findings. She underwent posterior instrumentation and decompression, with symptom relief, and remained asymptomatic on follow-up. Translational thoracic spine fractures, typically associated with neurological deficits, can be missed when neurology is intact. Timely imaging and intervention are crucial for optimal outcomes. https://www.jnma.com.np/jnma/index.php/jnma/article/view/9126decompressionintact neurologyposterior instrumentationtranslational fracture
spellingShingle Niraj Kumar Sharma
Rishi Ram Banjade
Sabin Pokharel
Sharmila Ghimire
Missed T8-T9 translational fracture with intact neurology: A Case report
Journal of Nepal Medical Association
decompression
intact neurology
posterior instrumentation
translational fracture
title Missed T8-T9 translational fracture with intact neurology: A Case report
title_full Missed T8-T9 translational fracture with intact neurology: A Case report
title_fullStr Missed T8-T9 translational fracture with intact neurology: A Case report
title_full_unstemmed Missed T8-T9 translational fracture with intact neurology: A Case report
title_short Missed T8-T9 translational fracture with intact neurology: A Case report
title_sort missed t8 t9 translational fracture with intact neurology a case report
topic decompression
intact neurology
posterior instrumentation
translational fracture
url https://www.jnma.com.np/jnma/index.php/jnma/article/view/9126
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AT sabinpokharel missedt8t9translationalfracturewithintactneurologyacasereport
AT sharmilaghimire missedt8t9translationalfracturewithintactneurologyacasereport