Pediatric Radiology

, Volume 33, Issue 5, pp 305–310 | Cite as

Thoracolumbar fracture with listhesis—an uncommon manifestation of child abuse

  • Terry L. LevinEmail author
  • Walter E. Berdon
  • Ian Cassell
  • Netta M. Blitman
Original Article



Thoracolumbar fracture with listhesis (FL) is an uncommon manifestation of child abuse (increasingly known as nonaccidental trauma), with only six prior reports in the literature.


This article seeks to call attention to FL of the thoracolumbar spine in abused children and infants.

Materials and methods

We reviewed plain films, CT and MR images in seven new cases of FL of the thoracolumbar spine in abused children ages 6 months to 7 years, two of whom became paraplegic from their injuries.


Findings varied from subtle listhesis of one vertebra on another to frank vertebral dislocation, most commonly at L1/2. Paravertebral calcification was present in all but one case. In two children, thoracolumbar FL was the only radiographic sign of abuse.


Radiographic findings of FL of the thoracolumbar spine may be subtle and may be erroneously interpreted as due to a congenital or neoplastic cause. While other signs of child abuse should be sought, spinal injury may be the sole sign of abuse. Recognition of this entity is important to pursue the diagnosis of abuse.


Abuse Nonaccidental trauma Spine Fracture Dislocation 


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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • Terry L. Levin
    • 1
    Email author
  • Walter E. Berdon
    • 2
  • Ian Cassell
    • 3
  • Netta M. Blitman
    • 1
  1. 1.Department of RadiologyMontefiore Medical CenterBronx, New YorkUSA
  2. 2.Department of RadiologyBabies Hospital, New York Presbyterian HospitalNew YorkUSA
  3. 3.Department of RadiologyPhoenix Children's HospitalPhoenixUSA

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