Hemodynamically Unstable Multi Trauma Patient with Unstable Pelvis and Incomplete Spinal Cord Injury

A 47 year old male, was brought to the trauma bay after a motorcycle accident .The patient presented with severe back pain and couldn’t move his legs (Incomplete Spinal cord injury-

ASIA B). The patient presented with level three shock, unstable BPs, and a dropping Hb levels.

The patient had a normal Chest x-ray and negative FAST was identified. On his pelvis X-ray, a pelvic fracture was noted (Young and Burgess Classification APC type 2).

Due to shock, a massive transfusion protocol was started (the patient received a total of 24 units of blood), and a pelvic binder was applied. With the persistence of hypotension; he was intubated and ventilated, received inotropics and underwent an embolization of lateral sacral artery. When stabilized a total body CT was performed, diagnosing a unstable T10 vertebra fracture with cord compression.

The patient underwent a urgent decompression and fusion from T8-T12. With motor return.

A week later, he underwent anterior plating of the pelvis fracture and percutaneous posterior sacroiliac screws with guidance of intraoperative CT.

Normal operative courses.

After 1 month he was discharged to rehabilitation. At 5 months follow up, he can walk on his both legs without assisted devices with improvement to ASIA D status.