Child Abuse with Thoracolumbar Fracture-Dislocation Treated with Pedicle Screw Fixation in a 2-Year-Old

CASE: A nonverbal 2-year-old boy presented with acute-on-chronic thoracolumbar fracture-subluxation with associated chylothorax and progressive neurologic dysfunction secondary to nonaccidental trauma. We discussed the successful management of this patient with short-segment pedicle screw instrumentation resulting in complete resolution of his chylothoraxes and neurologic impairment. A clinical follow-up is reported out to 12 months after hardware removal. CONCLUSION: Thoracolumbar fracture-subluxation with massive chylothorax is a rare and important presentation of nonaccidental trauma that must be recognized. Temporary pedicle screw fixation is a successful treatment option for young children presenting with this difficult spinal pathology.