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. 2017 May 26:8:89.
doi: 10.4103/sni.sni_434_16. eCollection 2017.

Traumatic spondyloptosis of the cervical spine: A case report and discussion of worldwide treatment trends

Kelly E Wong  1 , Peter S Chang  1 , Mark S Monasky  2 , Rodney M Samuelson  2
Affiliations

Traumatic spondyloptosis of the cervical spine: A case report and discussion of worldwide treatment trends

Kelly E Wong et al. Surg Neurol Int. .

Abstract

Background: Cervical spondyloptosis is defined as the dislocation of the spinal column most often caused by trauma. Due to compression or transection of the spinal cord, severe neurological deficits are common. Here, we review the literature and report a case of traumatic C5-6 spondyloptosis that was successfully treated using an anterior-only surgical approach.

Methods: The patient presented with quadriplegia and absent sensation distal to the C5 dermatome following a rollover motor vehicle accident. The preoperative American Spinal Injury Association Impairment Scale was A. Computed tomography of the cervical spine revealed C5-6 spondyloptosis, lamina fractures on the right side at the C3-4 level, and widened facet joint on the right side at C6-7.

Results: The patient underwent cervical traction and anterior cervical discectomy and fusion at the C5-6, C6-7 levels; no 360° fusion was warranted. Six months postoperatively, the patient remained quadriplegic below the C5 level.

Conclusion: Presently, no consensus is present regarding the best treatment for spondyloptosis. Worldwide, the 360° approach is the most commonly used (45%), followed by anterior-only surgery (31%) and posterior-only surgery (25%). The surgical choice depends upon patient-specific features but markedly varies among geographical regions.

Keywords: Cervical; spondylolisthesis; spondyloptosis; trauma.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Axial (a) and midsagittal reconstruction (b) of the cervical spine CT at the C5–6 level demonstrating complete spondyloptosis, with the body of the C5 vertebra placed in front of that of the C6 vertebra
Figure 2
Figure 2
Postoperative lateral (a) and anterior–posterior (b) radiograph shows reduction and C5–6–7 anterior cervical disc fusion
Figure 3
Figure 3
CT angiography taken on postoperative day 2 revealed 100% occlusion of the left vertebral artery within the left transverse foramen. The dissection extends from the origin at the subclavian to the C4–5 level. The contralateral vertebral artery of the patient
Figure 4
Figure 4
The left vertebral artery distal to the occlusion shows reconstitution from the muscular collaterals and is contiguous with the patient contralateral vertebral artery
Figure 5
Figure 5
Lateral plain radiograph obtained 1.5 months postoperatively reveals satisfactory alignment surrounding the instrumentation
See this image and copyright information in PMC

References

    1. Acikbas C, Gurkanlar D. Post-traumatic C7-T1 Spondyloptosis in a patient without neurological deficit: A case report. Turk Neurosurg. 2010;20:257–60. - PubMed
    1. Dahdaleh NS, Dlouhy BJ, Greenlee JD, Smoker WR, Hitchon PW. An algorithm for the management of posttraumatic cervical spondyloptosis. J Clin Neurosci. 2013;20:951–7. - PubMed
    1. Goffin J, Grob D. Spondyloptosis of the cervical spine in neurofibromatosis. A case report. Spine. 1999;24:587–90. - PubMed
    1. Jayakumar P, Choi D, Casey A. Late presentation of a type III axis fracture with spondyloptosis. Ann R Coll Surg Engl. 2008;90:W1–3. - PMC - PubMed
    1. Keskin F, Kalkan E, Erdi F. The surgical management of traumatic c6-c7 spondyloptosis. J Korean Neurosurg Soc. 2013;53:49–51. - PMC - PubMed

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