Two case reports of ‘locked spondyloptosis’: the most severe traumatic cervical spondyloptosis with locked spinous process and vertebral arch into the spinal canal

Tsujimoto, Takeru; Suda, Kota; Harmon, Satoko Matsumoto; Komatsu, Miki; Takahata, Masahiko; Iwasaki, Norimasa; Minami, Akio

doi:10.1038/s41394-020-0259-8

Cited by 9 publications

(7 citation statements)

References 15 publications

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“…[ 13 ] Some interesting particular forms of TCS were reported; Tsujimoto et al described the “locked spondyloptosis” where posterior arch including spinous process is in the spinal canal. [ 1 ] Another case was reported by Özdoğan et al of a TCS with a single body isolated from above and beneath bodies. [ 14 ] Reduction with transcranial traction was attempted in most cases; it was successful in one-third of the cases with an average weight of ≈12 Kg in 6 days.…”

Section: Discussionmentioning

confidence: 99%

“…Traumatic cervical spine spondyloptosis (TCS) is the most severe form of cervical spine injuries. [ 1 ] Many classifications have been proposed for cervical spine spondylolisthesis; all these classifications have strength and weakness points; and some descriptions of the lesions although valid and useful such as burst fracture and teardrop fracture, they are still general. [ 2 ] Meyerding's classification of spondylolisthesis defines spondyloptosis or Grade V as more than 100% slippage.…”

Section: Introductionmentioning

confidence: 99%

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Traumatic cervical spine spondyloptosis: A systematic review

Khelifa

Berchiche

Aichaoui

et al. 2022

J Craniovert Jun Spine

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Background: Spondyloptosis is a rare presentation of cervical spine traumatism where listhesis is more than 100%. Traumatic cervical spine spondyloptosis (TCS) is one of the least discussed forms of cervical spine traumatisms because of its rarity and the gravity of patient's condition, limiting good management, and the number of reported cases. Objectives: This study aimed to discuss clinical, radiological, and best management tools of the aforementioned pathology. Materials and Methods: Scopus, ScienceDirect, PubMed, and Google Scholar databases were searched for English articles about traumatic cervical spondyloptosis. Titles, abstracts, or author-specified keywords that contain the words “spondyloptosis” AND “cervical” AND “spine” were identified. There were no time limits. In sum, 542 records were identified, 63 records were screened, and 46 records were included in this review, describing 64 clinical cases of traumatic cervical spondyloptosis. The clinical cases of two patients managed at our department are also presented and included. In the end, 66 cases were included in this study. Demographics, clinics, radiology, management tools, and outcome of the reviewed cases were discussed. This study was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement 2009. The American Spinal Injury Association Impairment Scale (AIS) score was used to evaluate the clinical presentations. Results: This review included 66 patients consisting of 46 males (70%) and 20 females (30%), with a mean age of 41 years. The accident was indicated in 62 cases; it was a road traffic accident in 29 cases (46%), a fall in 24 cases (38%), and motor vehicle accident in 15 cases (24%). The lesion was iatrogenic in four patients. Twenty-one patients were received without motor or sensitive deficit and so scored Grade E on AIS, 10 with Grade D, 11 Grade C, four Grade B, and 20 with Grade A. On imaging, spondyloptosis involved the C1–C2 segment in two cases (3%), C2–C3 in three cases (5.5%), C3–C4 in one case (1.5%), C4–C5 in six cases (9%), C5–C6 in nine cases (13%), C6–C7 in 20 cases (30%), and C7–T1 in 26 cases (38%). In all cases, there was either fracture or dislocation in posterior elements. Bilateral pedicles or facet joint fractures were noted in 53% of the 56 patients where the associated lesions were described, but it jumps to 89% when a vertebra is projected in front of another. In two cases, there was no mention of closed reduction via transcranial traction; in 13 cases (20%), it was avoided for a reason (child, patient's refusal,…). In the 51 cases where the traction was clearly applied, 17 cases (33%) were reduced totally; in 13 cases (25%) the reduction was partial; it failed in 19 cases (37%); and in the remaining cases, the result was not clear. Traction weight varied from 4 kg to 27.2 kg, applied from 6 h to 20 days. Where total reduction was achieved, an average weight...

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Traumatic cervical spine spondyloptosis: A systematic review

Khelifa

Berchiche

Aichaoui

et al. 2022

J Craniovert Jun Spine

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show abstract

“…It is more common in the lumbar spine than in the cervical spine and can be seen following birth trauma, congenital conditions of the cervical spine (like absent cervical pedicles or corticated defect in pars interarticularis), neoplastic diseases (like neurofibromatosis or aneurysmal bone cyst) and after vehicle or diving trauma [4]. Traumatic cervical spine spondyloptosis is a very rare entity and is considered the most severe form of cervical spine injuries [5]. A systematic review published in 2023 was reported only 66 cases [2].…”

Section: Discussionmentioning

confidence: 99%

Successful management of traumatic cervical spondyloptosis with incomplete neurological deficit in a child: A case report

Ouattara,

DAO,

OUEDRAOGO

et al. 2024

Preprint

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“…However, some authors have reported anterior only or posterior only approaches with good results. 1,6,9,12,17,18 Dahdaleh et al, 12 however, proposed that after initial anterior fusion, posterior fusion is done only if there is documented segmental instability on intraoperative fluoroscopy.…”

Section: Managementmentioning

confidence: 99%