Background: There are very few reports in the literature that describe total anterolateral fracture dislocation of L4 and L5. To present a case report of L4-L5 total dislocation with major neurological deficit and open fracture of left distal femur.
Case Report: A 45-year-old Thai woman was transported to hospital with severe trauma, low back pain, a shallow lacerated wound on her back, and ecchymosis around waist and trunk. Closed reduction was initially performed and followed with posterior decompression, fusion, and instrumentation with pedicular screws and rod systems from L3-S1. Open reduction and internal fixation of distal femur was then performed.
Conclusion: At 1-year follow-up, the patient could ambulate with left ankle-foot orthosis (AFO) using a walker.

Keywords: Dislocations, Spine, Cauda equina syndrome, L4-L5 lumbar dislocation, Double vertebral bodies sign, Total
dislocation