An algorithm for the management of posttraumatic cervical spondyloptosis

Dahdaleh, Nader S.; Dlouhy, Brian J.; Greenlee, Jeremy D.W.; Smoker, Wendy R. K.; Hitchon, Patrick W.

doi:10.1016/j.jocn.2012.08.008

Cited by 22 publications

(19 citation statements)

References 24 publications

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“…[11] In certain cases, patients presented with a partial or complete spinal cord injury but a normal neurological exam. [1248910111213] The incidence of spondyloptosis at the C6–7 or C7–1 level is more common than that at all other levels combined.…”

Section: Discussionmentioning

confidence: 99%

Traumatic spondyloptosis of the cervical spine: A case report and discussion of worldwide treatment trends

Wong¹,

Chang²,

Monasky³

et al. 2017

Surg Neurol Int

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Background:Cervical spondyloptosis is defined as the dislocation of the spinal column most often caused by trauma. Due to compression or transection of the spinal cord, severe neurological deficits are common. Here, we review the literature and report a case of traumatic C5–6 spondyloptosis that was successfully treated using an anterior-only surgical approach.Methods:The patient presented with quadriplegia and absent sensation distal to the C5 dermatome following a rollover motor vehicle accident. The preoperative American Spinal Injury Association Impairment Scale was A. Computed tomography of the cervical spine revealed C5–6 spondyloptosis, lamina fractures on the right side at the C3–4 level, and widened facet joint on the right side at C6–7.Results:The patient underwent cervical traction and anterior cervical discectomy and fusion at the C5–6, C6–7 levels; no 360° fusion was warranted. Six months postoperatively, the patient remained quadriplegic below the C5 level.Conclusion:Presently, no consensus is present regarding the best treatment for spondyloptosis. Worldwide, the 360° approach is the most commonly used (45%), followed by anterior-only surgery (31%) and posterior-only surgery (25%). The surgical choice depends upon patient-specific features but markedly varies among geographical regions.

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Section: Discussionmentioning

confidence: 99%

Traumatic spondyloptosis of the cervical spine: A case report and discussion of worldwide treatment trends

Wong¹,

Chang²,

Monasky³

et al. 2017

Surg Neurol Int

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“…We could only achieve partial reduction till grade 3 on applying traction preoperatively. However, Dahdaleh 13 While attempting open reduction after failed/partial closed reduction, all the authors have used posterior approach to release the muscle/ligaments ± facetectomies. We have used only anterior single-step approach to reduce the listhesis completely and then did ACDF.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Cervical Spondyloptosis: Review of Literature and Case Report

Singh

Garg

2019

IJNT

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“…This is a common feature among the majority of previously reported cases, largely the presence of bilateral pedicle fractures, facet fractures, and/or laminar factures. [ 1 2 3 5 7 9 10 ] Theoretically, this fracture pattern permits natural decompression at the level of the dislocation due to broadening of the spinal canal. [ 1 2 3 5 7 9 10 ] Merianos et al .…”

Section: Discussionmentioning

confidence: 99%

Traumatic high-grade spondylolisthesis at C7-T1 with no neurological deficits: Case series, literature review, and biomechanical implications

Nguyen

Soliman

Kurpad

2017

J Craniovert Jun Spine

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Traumatic high-grade spondylolisthesis in subaxial cervical spine is frequently associated with acute spinal cord injury and quadriparesis. There have been rare cases where such pathology demonstrates minimal to no neurological deficits. Assessment of the underlying biomechanics may provide insight into the mechanism of injury and associated neurological preservation. Patient 1 is a 63-year-old female presenting after a motor vehicle collision with significant right arm pain without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, associated with a locked facet on the left at C6/7 and a locked facet on the right at C7/T1, with a fracture of the left C7 pedicle and right C7 lamina. Patient 2 is a 60-year-old male presenting after a bicycle collision with transient bilateral upper extremity paresthesias without neurological deficits. Imaging demonstrated C7/T1 spondyloptosis, with fractures of bilateral C7 pedicles, C7/T1 facets, and C7 lamina. Patient 3 is a 36-year-old male presenting after a motor vehicle collision with diffuse tingling sensation throughout all extremities. His neurological examination was nonfocal. Imaging demonstrated a grade 4 spondylolithesis at C7/T1, associated with bilateral C7/T1 locked facets. From literature, most cases were noted to be dislocations resulting from fractures of the posterior elements. A minority of cases has been found to involve facet dislocations without fractures. Further biomechanical studies are needed to understand the underlying mechanisms.

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An algorithm for the management of posttraumatic cervical spondyloptosis

Cited by 22 publications

References 24 publications

Traumatic spondyloptosis of the cervical spine: A case report and discussion of worldwide treatment trends

Traumatic spondyloptosis of the cervical spine: A case report and discussion of worldwide treatment trends

Traumatic Cervical Spondyloptosis: Review of Literature and Case Report

Traumatic high-grade spondylolisthesis at C7-T1 with no neurological deficits: Case series, literature review, and biomechanical implications

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