C3–C4 spondyloptosis without neurological deficit—a case report

Srivastava, Sudhir; Agrawal, Kshitij; Sharma, Amit; Agrawal, Mukta; Bhosale, Sunil; Renganathan, Sankar Ram

doi:10.1016/j.spinee.2010.05.002

Cited by 29 publications

(14 citation statements)

References 16 publications

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“…[11] In certain cases, patients presented with a partial or complete spinal cord injury but a normal neurological exam. [1248910111213] The incidence of spondyloptosis at the C6–7 or C7–1 level is more common than that at all other levels combined.…”

Section: Discussionmentioning

confidence: 99%

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

Wong¹,

Chang²,

Monasky³

et al. 2017

Surg Neurol Int

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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.

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Section: Discussionmentioning

confidence: 99%

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

Wong¹,

Chang²,

Monasky³

et al. 2017

Surg Neurol Int

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“…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

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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.

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“…In brief, four patients underwent combined anterior and posterior instrumented fusion, three had anterior only constructs, and one patient refused surgery. [3][4][5][6][7][8][9] Of the five new patients reported herein, four had posterior-only fusion and one had anterior-only. Thus, it is evident from these 13 patients that treatment of spondyloptosis is inconsistent.…”

Section: Discussionmentioning

confidence: 99%