Pediatric lateral distraction injury of the lumbar spine: A case report

Background context Lateral distraction injuries represent a very rare pattern of injury with only five cases reported in the literature. Such injuries are a result of high-energy trauma and have a high association with severe concomitant injuries. All previous reports of this injury are in skeletally mature individuals, and this has not been previously described in young children. Purpose To report a case of a lateral distraction injury in a young child secondary to improper seat belt use. Study design Case report and review of the literature. Patient sample Case report of an 8-year-old girl involved in a highway speed head-on collision. Methods We report here on an 8-year-old girl who was lying supine in the backseat of a motor vehicle while wearing a lap belt when the vehicle was involved in a high-speed motor vehicle crash. She presented with focal back pain, abdominal pain, and a seat belt sign. Imaging demonstrated focal coronal plane deformity with unilateral ligamentous disruption. The patient was diagnosed with a ligamentous lateral distraction injury of the lumbar spine. This injury was treated with open reduction and posterior spinal fusion with pedicle screw fixation. Results The patient tolerated the procedure well and had an uneventful postoperative course. Conclusions In this case, we describe a lateral distraction injury in a young child secondary to improper seat belt use. This represents the first description of such an injury in this age group, and this case highlights the spectrum of injury caused by improper seat belt use in the pediatric population.