Assessment of the integrity of posterior ligament complex injury (PLC) is the most important factor for identifying unstable thoracolumbar fractures. There are clinical and radiological criteria for the assessment of PLC injury initially, confirmed further by MRI. The PLC injury can be present in a patient who didn’t fulfill the plain radiograph criteria. We report such an injury in a 29 yrs old man who sustained T9 wedge compression fracture. It looks stable fracture with no PLC injury according to the plain radiograph criteria and it was managed conservatively without doing MRI. But he developed progressive subluxation after 4wks when he was mobilized. The MRI showed PLC injury and he underwent long segment posterior pedicle screw fixation and fusion. This case shows the importance of MRI in assessment of PLC injury and the reliability of TLICSS classification system in the management of thoraco-lumbar fractures.
Key words: Thoraco lumbar fractures, posterior ligament complex (PLC) injury, plain radiograph criteria
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