Study design: Case reports of stage 4 compressive-extension injury (CES-4).
Objective: To present CES-4, which has been known as a theoretical stage.
Summary of background data: Compressive-extension stage 3 and 4 lesion has been considered as theoretical stages between the mild and advanced lesions of the compressive-extension phylogeny.
Methods: Clinical and radiologic details are presented documenting the CES-4 injury.
Results: The authors have encountered 2 cases of CES-4 injury and in this study report the radiographic findings and describe the surgical treatment of the cases.
Conclusion: CES-4 is not a theoretical stage.