Total Dislocation of Third and Fourth Lumbar Vertebrae - A Rare Case Report and Review Literature

Total Dislocation of Third and Fourth Lumbar Vertebrae - A Rare Case Report and Review Literature | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Total Dislocation of Third and Fourth Lumbar Vertebrae - A Rare Case Report and Review Literature Govind Jashvantlal PUROHIT This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8520513/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract AIM - Introduction: Dislocations of the mid-lumbar vertebrae are exceptional , very rare and results in unstable spine deformity and deformation, which lead to severe spinal cord injury and mortality . Only 16 cases found in the literature, All previously reported cases were treated surgically. We report a case of a male 45-year-old presented to our emergency department with complete dislocation of L3-L4 vertebrae , with neurological deficit . following injury back resulting from crash of motor lifting tripod falling heavy object on back of patient. The patient developed severe back pain and spinal deformity, and acute neurologic deficit both lower limbs with bowel bladder paralysis . Radiological examinations show complete anterior dislocation of L3 over L4. He also had injury right thigh leading to long spiral fracture of femur at subtrochanteric level . . Treatment: After initial assessment of trauma & patient care , initial surgery for fixation of femur was done. The anatomico pathological mechanism of injury is discussed, together with treatment, successful open reduction and stabilization by fixation long construct of pedicle instrumentation and spinal fusion . Outcomes: Postoperative digital radiography showed the correction of the spinal deformity with restoration of lumbar curve. The patient was pain-free and fully rehabilitated 6 months after the surgery. His neurological status improved from grade 0-1 to grade 2-3 with sphincter recovery. At the 1-year follow-up, the patient had pain free back with stable normal alignment. This helped in neurological recovery and was rehabilitated with assisted caliper walking.& good sphincter control. Conclusions: We report a case of L3 to L4 traumatic spondyloptosis that involved complete neural damage. Restoring stability and preventing secondary cord injury should be taken into consideration for better rehabilitation & neurological recovery. Orthopedics Dislocation mid lumbar spondyloptosis intervertebral fusion pedicle screws Full Text Additional Declarations The authors declare no competing interests. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8520513","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":569881523,"identity":"d6d43766-f708-4b7c-9947-5b4f02c1c47c","order_by":0,"name":"Govind Jashvantlal PUROHIT","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA2klEQVRIiWNgGAWjYJACZgYDBjl+9gYgAwoOEKHFwFiy5wBJWhgMEjfMSEBowQvMJXIfPi4o+GNsIPnG8HNBhQ0Df3sD4+ECPFosZ6QbG88wMJAzl84xlp5xJo1B4swBhsMz8GgxuJHGJs0D9Ivl7BwDad62wwwGEgkMh3mI0JK44eYZ498karnBY0acLZY9z5iNeQyMgYGcVmbNcyaNR+LMwQa8WszZ0xgf8/yRA0bl4c23eSps5Pjbmw9/xuswBJMDzAYqZmzAowFFC/sDvCpHwSgYBaNg5AIAHI1DPDSEKpEAAAAASUVORK5CYII=","orcid":"https://orcid.org/0000-0002-3769-0709","institution":"KHETESWAR MEDICAL EDUCATIONAL RESEARCH CENTRE","correspondingAuthor":true,"prefix":"","firstName":"Govind","middleName":"Jashvantlal","lastName":"PUROHIT","suffix":""}],"badges":[],"createdAt":"2026-01-05 11:04:41","currentVersionCode":1,"declarations":{"humanSubjects":true,"vertebrateSubjects":false,"conflictsOfInterestStatement":false,"humanSubjectEthicalGuidelines":true,"humanSubjectConsent":true,"humanSubjectClinicalTrial":false,"humanSubjectCaseReport":true,"vertebrateSubjectEthicalGuidelines":false},"doi":"10.21203/rs.3.rs-8520513/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8520513/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":99661393,"identity":"07b625a9-8cf7-49bc-9e19-c21243680e03","added_by":"auto","created_at":"2026-01-07 03:54:27","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":876072,"visible":true,"origin":"","legend":"","description":"","filename":"JOIOD25019661.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8520513/v1_covered_a5beb12c-8251-4ec6-96c6-20156881d604.pdf"}],"financialInterests":"The authors declare no competing interests.","formattedTitle":"\u003cp\u003eTotal Dislocation of Third and Fourth Lumbar Vertebrae - A Rare Case Report and Review Literature\u003c/p\u003e","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"kheteswar medical educational research centre ","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":" Dislocation, mid lumbar, spondyloptosis , intervertebral fusion, pedicle screws","lastPublishedDoi":"10.21203/rs.3.rs-8520513/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8520513/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eAIM - Introduction:\u003c/strong\u003e Dislocations of the mid-lumbar vertebrae are exceptional , very rare \u0026nbsp;and results in unstable spine deformity and \u0026nbsp;\u0026nbsp;deformation, which lead to severe spinal cord injury and mortality . Only 16 cases found in the literature, All previously reported cases were treated surgically.\u003c/p\u003e\n\u003cp\u003eWe report a case of a male 45-year-old presented to our \u0026nbsp;emergency department with \u0026nbsp;complete dislocation of L3-L4 vertebrae , with neurological deficit . following injury back \u0026nbsp;\u0026nbsp;resulting from crash of motor lifting tripod falling heavy object on back of patient. The patient developed severe back pain and spinal deformity, and acute neurologic deficit both lower limbs with bowel bladder paralysis . Radiological examinations show \u0026nbsp;complete anterior dislocation of L3 over L4. \u0026nbsp;He also had injury right thigh leading to \u0026nbsp;long spiral fracture of femur at subtrochanteric level . \u0026nbsp;.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTreatment: \u003c/strong\u003eAfter initial assessment of trauma \u0026amp; patient care , initial surgery for fixation of femur was done. The anatomico pathological mechanism of injury is discussed, together with treatment, successful open reduction and stabilization by fixation long construct of pedicle instrumentation and \u0026nbsp;spinal fusion .\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eOutcomes: \u003c/strong\u003ePostoperative digital radiography showed the correction of the spinal deformity with restoration of lumbar curve. The patient was pain-free and fully rehabilitated 6 months after the surgery. His neurological status improved from grade 0-1 to grade 2-3 with sphincter recovery. At the 1-year follow-up, the patient had pain free back with stable normal alignment. This helped in neurological recovery and was rehabilitated with assisted caliper walking.\u0026amp; good sphincter control.\u003cbr\u003e\n\u003cstrong\u003eConclusions: \u003c/strong\u003eWe report a case of \u0026nbsp;L3 to L4 traumatic spondyloptosis that involved complete neural damage. Restoring stability and preventing secondary cord injury should be taken into consideration for better rehabilitation \u0026amp; neurological recovery.\u003c/p\u003e","manuscriptTitle":"Total Dislocation of Third and Fourth Lumbar Vertebrae - A Rare Case Report and Review Literature","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-01-07 03:53:06","doi":"10.21203/rs.3.rs-8520513/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"1a11efe8-11b5-459f-a06c-d7afd6ee5752","owner":[],"postedDate":"January 7th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":60710661,"name":"Orthopedics"}],"tags":[],"updatedAt":"2026-01-07T03:53:06+00:00","versionOfRecord":[],"versionCreatedAt":"2026-01-07 03:53:06","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8520513","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8520513","identity":"rs-8520513","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}