Missed Traumatic Thoracic Spondyloptosis With no Neurological Deficit: A Case Report and Literature Review

Abstract

Introduction: Traumatic thoracic spondyloptosis is caused by high energy trauma and is usually associated with severe neurological deficit. Cases presenting without any neurological deficit can be difficult to diagnose and manage.

Case presentation: We reported a four-week spondyloptosis of the ninth thoracic vertebra over the tenth thoracic vertebra, in a 20-year-old male without any neurological deficit. The patient had associated chest injuries. The spine injury was managed surgically with in-situ posterior instrumentation and fusion. The patient tolerated the operation well and postoperatively there was no neurological deterioration or surgical complication.

Conclusions: Patients presenting with spondyloptosis with no neurological deficit can be managed with in-situ fusion via pedicle screws, especially when presenting late and with minimal kyphosis.

Keywords: Spondyloptosis; Thoracic; Traumatic.

Figure 1.. A) Radiograph showing spondyloptosis of the ninth thoracic vertebrae over the tenth thoracic vertebrae, B) Computerized Tomography (CT) confirming the dislocation and vertebral body fracture of the ninth vertebrae, C) Virtual reconstruction computerized tomography of the fracture dislocation, D) Transverse section of computerized tomography showing the ninth thoracic vertebra ahead of the tenth thoracic vertebrae.

Figure 2.. A) Anteroposterior radiograph of thoracic spine showing pedicle screw fixation at six levels (T5 to T7 and T10 to T12), B) Lateral radiograph showing in situ pedicle screw fixation with spondyloptosis of T9 over T10, C) Computerized tomography reconstructed image showing pedicle screw fixation at different levels, D) Transverse sections of computerized tomography showing in situ pedicle screw fixation.

Figure 3.. Follow-up Computerized Tomography, Sagittal Section Showing Bony Formation Between Tenth and Ninth Thoracic Vertebrae