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An unusual combination of a lumbar seat belt injury and hemorrhagic contusion of the lower thoracic cord in a 2-year-old child: a case report

We describe a previously unreported combination of lumbar flexion–distraction ligamentous disruption and incomplete thoracic spinal cord injury in a 2-year-old boy. Magnetic resonance imaging of the thoracolumbar spine showed hemorrhagic cord contusion at the T11–T12 level. Plain radiographs showed mild kyphosis of the L3–L4 segment. Fluoroscopy showed pathological motion at L3–L4 in flexion indicating a ligamentous injury. The lumbar spine was surgically stabilized and at 1-year follow-up, a remarkable neurological recovery was noted. We believe that physicians managing children with multiple trauma injuries should be aware of this rare type of injury that might be underdiagnosed.