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Background: Hyperextension thoracic spine fractures (HTSFs) typically involve the anterior ligamentous complex of the spine. These patients often present with paraplegia and warrant early surgical reduction/fixation even though few deficits resolve. Here, we present the unusual case of a 40-year-old male whose paraparetic deficit resolved following reduction/fixation of a T7-T8 HTSF. Case Description: A 40-year-old male presented with a thoracic computed tomography (CT) documented T7- T8 HTSF following a motor vehicle accident. His neurological examination revealed severe paraparesis, but without a sensory level (ASIA motor score 78). The chest CT angiogram scan revealed a hypodensity in the aorta, representing a small traumatic aortic dissection responsible for the patient’s right hemothorax; 450 ml of blood was removed on chest tube placement. He underwent urgent/emergent thoracic spine reduction and fixation at the T7-T8 level. Within 5 postoperative months, he recovered fully neurological function (ASIA motor score 100). Conclusion: We recommend urgent/emergent surgical reduction/stabilization for patients with thoracic HTSF to decrease offer the potential for neurological recovery and avoid secondary injury due to continued compression.

Hyperextension thoracic spine fracture with complete neurological recovery after surgical fixation: A case report