✓The authors describe a 36-year-old woman with traumatic lateral spondyloptosis at L-2 and complete cauda equina injury who experienced a remarkable recovery after delayed treatment. To the authors' knowledge, this is the first case of traumatic spondyloptosis at L2–3 described in the English literature. A review of previous cases of lumbar spondyloptosis suggests that the degree of anatomical injury found at surgery is a better predictor of patient outcome than fracture severity assessed radiologically. Concomitant multisystem injury is common with spine disruptions of this magnitude and may mask clinical neurological function. Even when delayed, operative decompression of these severe lesions should be considered because dramatic neurological recovery is possible.
The patient was treated under the assumption that penetrating foreign objects in continuity with the cerebrospinal fluid space and the outside environment should be removed as soon as possible. The patient was provided appropriate antibiotics to treat potential infection of normal pharyngeal flora and organisms unique to the marine environment. The patient recovered and did not experience any residual neurological deficit.
The authors describe a 36-year-old woman with traumatic lateral spondyloptosis at L-2 and complete cauda equina injury who experienced a remarkable recovery after delayed treatment. To the authors' knowledge, this is the first case of traumatic spondyloptosis at L2-3 described in the English literature. A review of previous cases of lumbar spondyloptosis suggests that the degree of anatomical injury found at surgery is a better predictor of patient outcome than fracture severity assessed radiologically. Concomitant multisystem injury is common with spine disruptions of this magnitude and may mask clinical neurological function. Even when delayed, operative decompression of these severe lesions should be considered because dramatic neurological recovery is possible.
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