Management of post-traumatic neglected cervical facet dislocation

Prabhat, Vinay; Boruah, Tankeshwar; Lal, Hitesh; Kumar, Rajeev; Dagar, Ashish; Sahu, Harekrushna

doi:10.1016/j.jcot.2016.10.002

Cited by 11 publications

(27 citation statements)

References 15 publications

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“…This corresponds to other studies such as by Saha et al 17 in which they found the distribution of disease to be 58.33% in the dorsal region, which is the highest followed by 25% in the lumbar region and 16.67% in the thoracolumbar region. Regarding the maximum level of affection of the disease, our study also corresponds to the studies by Prabhat et al 18 in which the distribution of disease is maximum, that is, at the T5–T9 level. This has implied that the thoracolumbar spinal TB cases are more present at the dorsal region than the lumbar and junctional regions.…”

Section: Discussionsupporting

confidence: 85%

Clinical Outcome of Single-Stage Decompression and Posterior Stabilization in Thoracolumbar Spinal Tuberculosis

Susanta

Biswaranjan

Balappa

et al. 2021

Indian Journal of Neurosurgery

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Background Thoracolumbar spine constitutes the most common site for spinal tuberculosis. Though the treatment of spinal tuberculosis is antitubercular drugs initially, the patient with neurologic weakness warrants definitive surgical procedure of decompression and stabilization. Even though many investigators have reported favorable results with anterior decompression and stabilization surgery, due to the increased morbidity and complications, the posterior-only approach with decompression and stabilization has evolved as the operation of choice in recent time. Methods All patients aged between 18 and 70 years with clinically and radiologically proven symptomatic thoracolumbar spinal tuberculosis who failed with conservative treatment for 4 weeks or developed neurologic weakness between the treatments are included in this study. All patients were offered decompression and posterior stabilization with transpedicular screws and rods after explaining the above procedure. Clinical outcome was measured by modified Frankel grading; AIS (American Spinal Injury Association impairment score) grade impairment score; and pain assessment done with visual analog scale (VAS) pre- and postoperatively and at 3, 6, and 9 months of interval. Results The postoperative pain relief, neurologic improvement as per modified Frankel grade, AIS grade, and improvement in erythrocyte sedimentation rate and C-reactive protein were significant as compared with the preoperative status. The surgical interventions thus prove to have adequate relief to the patient and arresting the disease progression. The surgical outcome has very minimal intra- and postoperative complications. Conclusion Single-stage decompression and posterior stabilization in thoracolumbar spinal tuberculosis is safe, effective, and results in good clinical outcome. The advantages of surgery include thorough debridement, decompression, and achievement of spinal stabilization.

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Section: Discussionsupporting

confidence: 85%

Clinical Outcome of Single-Stage Decompression and Posterior Stabilization in Thoracolumbar Spinal Tuberculosis

Susanta

Biswaranjan

Balappa

et al. 2021

Indian Journal of Neurosurgery

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“…Early management of these is critical for successful treatment and favorable outcome. [3] Delayed presentation is uncommon and especially seen in economically challenged countries. Guidelines for the management of neglected/delayed cases are unclear.…”

Section: Discussionmentioning

confidence: 99%

Autostabilization of neglected high-grade fracture–dislocation in the cervical spine

Shah¹,

Gadiya

Nene

2018

J Craniovert Jun Spine

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Neglected cervical spine trauma is rare with very few case series reported in literature. There are no clear guidelines for its treatment. If operative treatment is sought, the role of skull traction, type of approach (anterior only, posterior only, or combined), sequence of surgery, type of instrumentation, etc., have to be considered. Hence, the treatment is challenging. Autostabilization has been described in the natural history of degenerative lumbar spondylolisthesis. As a result, many patients are treated nonoperatively, obviating need of surgery. We report two cases of neglected/untreated fracture–dislocation at subaxial cervical spine. They presented with exertional neck pain. Computed tomography scan showed bony fusion at involved level. The patient was treated nonsurgically with favorable outcome at long-term follow-up. Our cases depict autostabilization in a case of neglected traumatic cervical spine injury, which is never been reported. Such patients do well with nonsurgical treatment, thus obviating need for extensive deformity correction.

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“…Such patients can become chronic if they fail to seek medical attention or rarely a missed diagnosis. [ 2 ] The management of these neglected cases is a matter of debate and surgically a mammoth challenge keeping in mind the risks involved. [ 2 3 ] However, maintaining cervical stability and alignment is a major requisite in preventing progressive deformity and late-onset neurological deficit.…”

Section: Introductionmentioning

confidence: 99%

“…[ 2 ] The management of these neglected cases is a matter of debate and surgically a mammoth challenge keeping in mind the risks involved. [ 2 3 ] However, maintaining cervical stability and alignment is a major requisite in preventing progressive deformity and late-onset neurological deficit. [ 4 ] Surgeons have different algorithms for their patients, and here, we describe our technique in such a unique situation.…”

Section: Introductionmentioning

confidence: 99%

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Neglected bilateral facet dislocation of the cervical spine with intact neurology: Reduction technique

2020

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Bilateral cervical facet dislocation is a serious injury that in majority cause neurologic deficit requiring prompt medical attention. Rarely, they retain normal neurology due to spontaneous decompression even though patients can have objective myelopathic or root compression signs. Neglected cases with normal neurology are uncommon with only few of them reported in the literature but their management is still a matter of debate. Here, we report a case of a 26-year-old female who had neglected bilateral facet dislocation with neck stiffness that was operated with posteroanterior approach with near-complete reduction and intact neurology. We describe the technique employed and discuss the literature.

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Management of post-traumatic neglected cervical facet dislocation

Abstract: Proper decompression, reduction and fixation should be done in neglected cervical dislocation as it provides mechanical stability and alignment, facilitates rehabilitation, prevent kyphotic deformity as well as offers a fair chance of neurological recovery.

Cited by 11 publications

References 15 publications

Clinical Outcome of Single-Stage Decompression and Posterior Stabilization in Thoracolumbar Spinal Tuberculosis

Clinical Outcome of Single-Stage Decompression and Posterior Stabilization in Thoracolumbar Spinal Tuberculosis

Autostabilization of neglected high-grade fracture–dislocation in the cervical spine

Neglected bilateral facet dislocation of the cervical spine with intact neurology: Reduction technique

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