The Surgical Management of Traumatic C6 - C7 Spondyloptosis in a Patient without Neurological Deficits

Menkü, Ahmet; Kurtsoy, Ali; Tucer, Bülent; Oktem, Ibrahim; Akdemir, Hidayet

doi:10.1055/s-2004-818496

Cited by 37 publications

(49 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Menku and his colleagues were the first to report such a case of (C6-C7 post-traumatic spondyloptosis without neurological deficits) (13). Our case is the first spondyloptosis of the cervicothoracic junction (C7-T1) without a neurological deficit.…”

Section: Discussionmentioning

confidence: 63%

Post-traumatic c7-t1 spondyloptosis in a patient without neurological deficit: a case report

Açikbas

Gürkanlar²

2009

Turkish Neurosurgery

View full text Add to dashboard Cite

Traumatic cervical spondyloptosis has almost always been associated with disabling neurological deficit and we could only find one case without a neurological deficit reported in the literature. A 42 year old man suffering from severe neck pain following a high speed motor vehicle accident was admitted to our hospital. Magnetic resonance imaging (MRI) and computerized tomography (CT) of the cervical spine and neurologic examination of the patient were performed. The patient was treated with three-column fixation of the traumatic level. We aimed to report a unique case of traumatic C7-T1 total spondyloptosis without a neurological deficit and discuss possible mechanisms and treatment modalities.

show abstract

Section: Discussionmentioning

confidence: 63%

Post-traumatic c7-t1 spondyloptosis in a patient without neurological deficit: a case report

Açikbas

Gürkanlar²

2009

Turkish Neurosurgery

View full text Add to dashboard Cite

show abstract

“…This, as in our case, is probably due to locked facets and the fibrosis or pseudoarthrosis formation at the level of the fracture (1). Additionally, some authors (6) suggest that cervical traction may lead to an increase in the initial neurological damage, especially in neurological intact patients. However, traction with less than 20 lb during 3-10 days seems to be safe according to the previous literature.…”

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

View full text Add to dashboard Cite

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...

show abstract

“…Cervical spondyloptosis is relatively rare, and most of the relevant literature is in the form of case reports or short case series. 1,2,4,5,11,17,20,35,36,38 Of note, cervical spondyloptosis has been reported in patients without neurological deficits. 1,20,36,39 Nontraumatic cervical spondyloptosis has been reported in the setting of aneurysmal bone cyst, neurofibromatosis, ankylosing spondylosis, or congenital absence of posterior elements of the cervical spine.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,4,5,11,17,20,35,36,38 Of note, cervical spondyloptosis has been reported in patients without neurological deficits. 1,20,36,39 Nontraumatic cervical spondyloptosis has been reported in the setting of aneurysmal bone cyst, neurofibromatosis, ankylosing spondylosis, or congenital absence of posterior elements of the cervical spine. 9,12,18,21,22,24 The first documented case of traumatic cervical spondyloptosis was of an 8-year-old girl treated with C5-7 corpectomies with in situ fusion using a tricorticate iliac bone graft from C4-T1.…”

Section: Discussionmentioning

confidence: 99%

Traumatic, high-cervical, coronal-plane spondyloptosis with unilateral vertebral artery occlusion: treatment using a prophylactic arterial bypass graft, open reduction, and instrumented segmental fusion

Manjila¹,

Chowdhry²,

Bambakidis³

et al. 2014

SPI

View full text Add to dashboard Cite

The authors present a case of traumatic, complete, high cervical spine injury in a patient with gradual worsening deformity and neck pain while in rigid cervical collar immobilization, ultimately resulting in coronal-plane spondyloptosis. Due to the extent of lateral displacement of the spinal elements, preoperative evaluation included catheter angiography, which revealed complete right vertebral artery (VA) occlusion. A prophylactic arterial bypass graft from the right occipital artery to the extradural right VA was fashioned to augment posterior circulation blood supply prior to reduction and circumferential instrumented fusion. Following surgery, the patient was able to participate in an aggressive rehabilitation program allowing early mobilization, and he ceased to be ventilator-dependent following implantation of a diaphragmatic pacer. The authors review factors leading to progression of this type of injury and suggest technical pearls as well as highlight specific management pitfalls, including operative risks.

show abstract

The Surgical Management of Traumatic C6 - C7 Spondyloptosis in a Patient without Neurological Deficits

Cited by 37 publications

References 5 publications

Post-traumatic c7-t1 spondyloptosis in a patient without neurological deficit: a case report

Post-traumatic c7-t1 spondyloptosis in a patient without neurological deficit: a case report

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

Traumatic, high-cervical, coronal-plane spondyloptosis with unilateral vertebral artery occlusion: treatment using a prophylactic arterial bypass graft, open reduction, and instrumented segmental fusion

Contact Info

Product

Resources

About