We report on a 46-year-old woman who was involved in a road traffic accident. Neurological examination demonstrated paraplegia, while initial CT showed bilateral pneumothorax and hemothorax, rib fractures, a C2 vertebral body fracture with C2-C3 dislocation and active arterial bleeding at the sacral level. Given the fact that her neurological status did not particularly correspond with what we observed on CT scan, MRI was obtained due to the suspicion that a much more severe occult injury could be present. MRI showed a complete rupture of the posterior ligamentous complex along with the intervertebral disk and the posterior longitudinal ligament at T8-T9 level. The patient underwent minimally invasive posterior fixation with pedicle screws. Chance fractures of the thoracic spine are uncommon. To our knowledge, this is the first report of a pure soft-tissue Chance fracture located in the thoracic spine. Given that the initial CT showed no fracture evidence or vertebral malalignment, a high index of suspicion, based on the mechanism of injury, clinical examination and/or concomitant lesions, is necessary to identify such extremely unstable injury. Early recognition is crucial for appropriate therapy and to minimize the extent of neurological deficit.

中文翻译：

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计算机断层扫描中隐匿性胸椎韧带机会性骨折：病例报告。

我们报告了一名46岁的妇女，她卷入了道路交通事故。神经系统检查显示为截瘫，而最初的CT显示双侧气胸和血胸，肋骨骨折，C2椎体骨折伴C2-C3脱位以及active骨活动性动脉出血。考虑到她的神经系统状况与我们在CT扫描中观察到的并不特别相符，因此由于怀疑可能存在更严重的隐匿性损伤而获得了MRI。MRI显示T8-T9水平的后韧带，椎间盘和后纵韧带完全破裂。病人用椎弓根螺钉进行微创后路固定。胸椎机会性骨折很少见。据我们所知，这是首次报告胸椎纯软组织机会骨折。鉴于最初的CT没有显示出骨折迹象或椎骨错位，因此，基于损伤的机理，临床检查和/或伴随的损伤，高度怀疑的证据对于鉴定这种极不稳定的损伤是必要的。早期识别对于适当的治疗并最大程度地减少神经功能缺损至关重要。