• Anouar Bourghli, Ibrahim Obeid, Louis Boissiere, Jean-Marc Vital, Zafer Tabboush, and Mohammed Al Sarawan.
• Orthopedic and Spinal Surgery Department, Kingdom Hospital, P.O.Box 84400, Riyadh, 11671, Saudi Arabia. anouar.bourghli@gmail.com.
• Eur Spine J. 2018 Jul 1; 27 (7): 1547-1552.

PurposeChance fracture of the high thoracic spine is rare, and its impact on the adjacent cervical spine can be important.MethodsWe present the case of a 16-year-old male, who fell down from a 2 m height, in an unknown context as he has a mental retardation, and no witness saw the accident. Initial CT scan revealed a comminuted depressed fracture of the right parietal bone, associated with a chance fracture at the level of T3 with a kyphosis and bilateral lung contusion.ResultsThe patient underwent neurosurgical treatment for elevation and reconstruction of the parietal fracture; he also underwent, 2 days later, a posterior spinal correction and fusion with T1-to-T5 instrumentation. The patient returned to normal walking on day 7 with a satisfactory clinical and radiological result at 1 year.ConclusionLiterature is sparse on the treatment of high thoracic chance fractures. The current case shows that early surgical management should prevent a secondary kyphotic deformity that may need a more aggressive treatment at a later stage.

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