The Surgical Management of Traumatic C6-C7 Spondyloptosis

Keskin, Fatıh; Kalkan, Erdal; Erdi, Fatih

doi:10.3340/jkns.2013.53.1.49

Cited by 13 publications

(14 citation statements)

References 3 publications

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“…The appropriate surgical methods are controversial, with every approach having pros and cons. However, considering the biomechanics, an initial anterior discectomy followed by a posterior reduction (if not reduced with instrumented fusion) followed an anterior fusion procedure seems to be the most appropriate as it provides the best stability and also prevents any chance of disc compression while the reduction is done in the prone position [15]. In patients in whom complete reduction is achieved, management by anterior discectomy and fusion followed by posterior instrumented fusion can be used (Fig.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Cervical Spondyloptosis of the Subaxial Cervical Spine: A Case Series with a Literature Review and a New Classification

2016

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Study DesignThis is a retrospective study on patients with traumatic subaxial cervical spondyloptosis and includes a review of the available literature regarding the management of this injury.PurposeThis study aimed to assess the biomechanics and varied clinical presentations of this rare but devastating injury.Overview of LiteratureThis is a case series of three patients and a review of the available literature on subaxial cervical spondyloptosis. Traumatic cervical spondyloptosis of the subaxial spine is rare, with varied clinical presentations.MethodsThe management of cervical subaxial spondyloptosis represents a challenge to all spine care specialists, and there is a paucity of literature on the best methods for managing this condition. Our experience includes three such patients who visited our tertiary trauma center. This article explains the diverse clinical features of the injury as well as the management of these patients and includes a review of the available literature.ResultsSubaxial cervical spondyloptosis is a devastating injury with diverse clinical features. We present a classification of these fractures based on clinical presentation and magnetic resonance imaging results, which can help in decision-making regarding the management of such patients.ConclusionsThis article may help physicians assess this injury in an evidence-based manner and also elucidates the management strategies available for such patients.

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Section: Discussionmentioning

confidence: 99%

Traumatic Cervical Spondyloptosis of the Subaxial Cervical Spine: A Case Series with a Literature Review and a New Classification

2016

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“…Regarding complications, CSF leaks due to high-grade dislocation (noniatrogenic) have been seen by few authors including us but none of the authors reported meningitis or wound leaks afterwards. 12,14 Our patient had meningitis which led to hydrocephalus and subsequent septicemia leading to death of the patient.…”

Section: Discussionmentioning

confidence: 85%

Traumatic Cervical Spondyloptosis: Review of Literature and Case Report

Singh

Garg

2019

IJNT

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“…The most accepted approach is the combined anterior and posterior 360º or 540º, with or without corpectomies. This approach provides wide canal decompression and successful cervical spine realignment (1)(2)(3)(4)(5)(6)(7)(10)(11)(12)(13). Additionally, the management of chronic spondylisthesis would have some considerations according to our experience.…”

Section: Discussionmentioning

confidence: 99%

“…The initial management of these fractures is generally a cervical traction to achieve a closed reduction that may allow a subsequent spinal stabilization with an anterior, posterior or combined approach (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Nevertheless, in the chronic spondyloptosis (4) or high grade spondylolisthesis the treatment of the patient became a challenge to achieve a correct spinal alignment avoiding the worsening of the neurological status.…”

Section: Case Reportmentioning

confidence: 99%

Treatment of chronic traumatic C7–T1 grade III spondylolisthesis with mild neurological deficit: case report

et al. 2017

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Traumatic cervical severe spondylolisthesis is a rare and severe lesion which is typically associated with a spinal cord injury. Nevertheless, it occasionally has a pauci-symptomatic course which may delay its diagnosis. The authors report an exceptional case of a 33-year-old woman who had mild spasticity in her lower limbs and neck pain 9 months after a traffic accident. The computed tomographic scan and magnetic resonance image revealed C7-T1 grade III spondylolisthesis and spinal cord signal change. The initial cervical traction did not obtain a spinal realignment. An anterior-posterior approach was performed to achieve a correct spinal fusion. After 18 months of follow-up care, the patient's symptoms improved significantly and she began to lead a normal life again. The case underlines the importance of performing a correct initial diagnostic workup upon a patient. This would improve surgical management by avoiding a worsening of the initial neurological deficit during the realignment maneuvers in the chronic grade III, IV or V spondylolisthesis. Case ReportTraumatic subaxial cervical luxations are typically produced by high-energy mechanisms and are associated with major spinal cord injury and mechanical instability. Cervicothoracic spondyloptosis or severe spondylolisthesis is an especially severe injury, usually with an easy diagnosis in the initial evaluation of a traumatic patient. Although there are cases reported of neurologically intact patients, the delay in the diagnosis is extremely rare (1,2). We present a case of a C7-T1 grade III spondylolisthesis identified 9 months after the traumatic event with mild progressive pyramidal symptoms in the lower limbs.The initial management of these fractures is generally a cervical traction to achieve a closed reduction that may allow a subsequent spinal stabilization with an anterior, posterior or combined approach (1-12). Nevertheless, in the chronic spondyloptosis (4) or high grade spondylolisthesis the treatment of the patient became a challenge to achieve a correct spinal alignment avoiding the worsening of the neurological status. Case presentationA 33-year-old female, without other medical pathologies or neurological damages, was admitted to the emergency room after a road traffic collision. The initial neurological examination was normal. The cervical spine plain radiography, in which the cervicothoracic union was not well defined, was considered normal (Figure 1). The patient was discharged with mild cervical pain. The pain remained approximately 8 weeks after the accident but no more radiological exams were made. Progressive subjective mild motor weakness and numbness of the lower limbs appeared progressively six-seven later. Nine months after the accident she was evaluated by a neurologist. The J Spine Surg 2017;3(1):82-86 jss.amegroups.com exploration revealed brisk reflexes in her lower limbs and decreased sensation at level at C7; there were no objective motor deficits (ASIA score D). The cervicothoracic MRI and CT (Figures 2,3) showed a C7-T1 tr...

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The Surgical Management of Traumatic C6-C7 Spondyloptosis

Cited by 13 publications

References 3 publications

Traumatic Cervical Spondyloptosis of the Subaxial Cervical Spine: A Case Series with a Literature Review and a New Classification

Traumatic Cervical Spondyloptosis of the Subaxial Cervical Spine: A Case Series with a Literature Review and a New Classification

Traumatic Cervical Spondyloptosis: Review of Literature and Case Report

Treatment of chronic traumatic C7–T1 grade III spondylolisthesis with mild neurological deficit: case report

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