Neglected cervical spondyloptosis of the 5TH – 6TH cervical spine following cervical manipulation: A case report

Sakti, Yudha Mathan; Anzhari, Sharfan; Kartika, Andrea; Irfantian, Ardicho; Ahmad, Husein; Sakadewa, Galih Prasetya; Alhaq, Zaky Asad; Resubun, Alan Philips Kustianto Putra; Tarsan, Andi Karsapin

doi:10.1016/j.ijscr.2022.106984

Cited by 3 publications

(8 citation statements)

References 11 publications

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“…2). Our observation is in contrast with a previous report 8 and recommendation 13 on the non-effectiveness of preoperative cervical traction in neglected cervical spondyloptosis.…”

Section: Discussioncontrasting

confidence: 99%

“…The time of presentation from trauma ranges from a few hours to eight years. 2,3,9,13,14 Interestingly, our patient and those reported by Gascol et al 8 , Sakta et al 13 , and a case reported by Padwal et al 15 , all presented eight months following trauma.…”

Section: Discussionsupporting

confidence: 58%

“…However, unusual mechanisms such as vaginal delivery, intubation, spinal massage or manipulation, and indoor slippage and fall, as in our index case, have been reported. 9,[11][12][13] Available data show that the C7-T1 level was the most affected segment. 3,14 Six cases of C4-C5 level involvement, similar to our index case, have been reported and are summarized in Table 1.…”

Section: Discussionmentioning

confidence: 99%

“…Initially, surgical reduction was thought to be unsafe, and at present, combined anterior and posterior approaches appear to be frequently performed, with proponents advocating better stabilization and cord decompression. 12,13,17,18 In our case, an anterior-only approach was chosen to address the marked anterior cord compression and excise the deformed and osteopenic C5 and C6 vertebrae bodies with pseudoarthrosis, to enable adequate decompression and instrumented fusion. A similar application of this procedure has been reported with an excellent outcome.…”

Section: Discussionmentioning

confidence: 99%

“…6 The paucity of specialist facilities, overlooked or missed diagnoses, ignorance, poverty, and unregulated proliferation of traditional healers have been implicated in delayed presentation. 5,13 This is coupled with locoregional challenges such as poor health-seeking attitudes, limited health insurance coverage, reduced manpower from brain drain, limited theatre spaces, and state-of-the-art neurosurgical facilities. 16 Our index case initially sought care with a traditional healer before presenting to our facility, thereby exhausting their limited funds before presenting in our facility.…”

Section: Discussionmentioning

confidence: 99%

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Management of Neglected Post-traumatic C4/C5 Spondyloptosis in a Low Resource Setting: a Review of Literature and Case Study.

Anele,

Ezeaku,

Balogun

et al. 2024

Preprint

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Objectives To highlight the incidence, outcome, and peculiar management challenges of cervical spondyloptosis Methods A retrospective literature review and case study Results Five cases of subaxial cervical spondyloptosis were identified from the literature and reviewed. Their demographics, mechanisms of trauma, intervention, and outcome were highlighted. Conclusion Subaxial cervical spondyloptosis is relatively uncommonly documented in the literature. The management outcomes are variable, and peculiar management challenges are highlighted in the index case study.

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“…2). Our observation is in contrast with a previous report 8 and recommendation 13 on the non-effectiveness of preoperative cervical traction in neglected cervical spondyloptosis.…”

Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Management of Neglected Post-traumatic C4/C5 Spondyloptosis in a Low Resource Setting: a Review of Literature and Case Study.

Anele,

Ezeaku,

Balogun

et al. 2024

Preprint

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Reduction of cervicothoracic spondyloptosis in an ambulatory patient: when traction fails

Judy,

Tracz,

Rincon-Torroella

et al. 2023

Spinal Cord Ser Cases

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Traumatic spinal spondyloptosis presenting in a tertiary care unit in central Nepal

Munakomi

2023

F1000Res

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Introduction: Traumatic spinal spondyloptosis, though rare, harbingers a high risk of mortality as well as permanent and disabling neurological deficits. They invariably become socially aloof and marginalized in most parts of our subcontinent owing to the lack of dedicated rehabilitation units amid their poor economic status. There is a paucity of studies pertaining to such rare epiphenomenon within our region. Materials and Methods: A study of 16 patients presenting with spinal spondyloptosis from January 2017 to January 2023 in a tertiary care center in Nepal was undertaken. The clinical records of the patients were retrieved from the hospital record section to study the demographic variables, modes of injury, American Spinal Injury Association (ASIA) grades, salient radiological characteristics, management strategies, and the resultant clinical outcomes. Result: The mean age of the cohorts in our study was 40 years with an age range of 25-80 years. Most of the patients presented in ASIA ‘A’ neurological grade (75%). The cervical spine was involved in the majority (68.75%) of cases. 8 (50%) patients left against medical advice, 2 (12.5%) were managed conservatively, and 6 (37.5%) were operated. The posterior-only approach was undertaken in 4(66.67%) cases. Tracheo-oesophageal fistula occurred in 2 (33.33%) patients. And cerebrospinal fluid (CSF) leak occurred in 2 (33.33%) patients. The overall hospital mortality was 3(37.5%). All the surviving patients were of the ASIA ‘E’ grades. Conclusion: There is a continuum of physical, economic, psychological, and social burdens to both the patients and their care providers. Rehabilitation is the ‘bottleneck’ variable governing poor outcomes in our subcontinents. The poor economic status of the people has a ripple effect upon the same. This should also aid in the patient counseling as well as fostering the notion of the paramount need for dedicated neuro-rehabilitation units in our regions.

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Neglected cervical spondyloptosis of the 5TH – 6TH cervical spine following cervical manipulation: A case report

Cited by 3 publications

References 11 publications

Management of Neglected Post-traumatic C4/C5 Spondyloptosis in a Low Resource Setting: a Review of Literature and Case Study.

Management of Neglected Post-traumatic C4/C5 Spondyloptosis in a Low Resource Setting: a Review of Literature and Case Study.

Reduction of cervicothoracic spondyloptosis in an ambulatory patient: when traction fails

Traumatic spinal spondyloptosis presenting in a tertiary care unit in central Nepal

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