Partial Vertebrectomy in Neglected Spondyloptosis at the T10–11 Level: A Case Report

Abstract

Our objective was to document the surgical results from a case and conduct a retrospective analysis of partial vertebrectomy in neglected spondyloptosis at the T10–11 level. Traumatic spondyloptosis is a severe and rare spinal cord injury. In spondyloptosis, there is a traumatic subluxation of adjacent vertebral bodies that exceeds the normal anatomical limits. The thoracic vertebrae possess a rigid skeleton, and the sternum also contributes to maintaining stability in the upper-middle chest area. Therefore, instances of spondyloptosis in the thoracic spine are exceedingly rare. Thoracic spondyloptosis typically results in neurological deficits. A 45-year-old man presented to the neurosurgery outpatient clinic complaining of weakness of lower extremities, back pain, headache, and vomiting. The patient was hospitalized for 7 days, and he was diagnosed with neglected spondyloptosis based on a computed tomography scan. The patient was treated using laminectomy decompression, bilateral facetectomy, partial vertebrectomy, and posterior stabilization. Management in cases of spondyloptosis has the aim of reduction, alignment, and stabilization. Early surgery with reduction and rigid stabilization is preferable to conservative treatment in most cases. The surgical approach can be anterior, posterior, or combined, without significant differences. Vertebrectomy is performed to remove part of the vertebral body to reduce spinal cord pressure. Thoracic spondyloptosis is a very rare but severe type of spinal cord injury. Neurological deficits are common in patients with this condition. Early management involving reduction and stabilization is generally recommended to obtain a better outcome.