Traumatic spondylolisthesis and spondyloptosis of the subaxial cervical spine without neurological deficits: closed re-alignment, surgical options and literature review

Ramieri, Alessandro; Domenicucci, Maurizio; Cellocco, Paolo; Lenzi, Jacopo; D, De Santis; Costanzo, Giuseppe

doi:10.1007/s00586-014-3560-z

Cited by 26 publications

(31 citation statements)

References 22 publications

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“…Lack of proper guideline leaves certain important questions unanswered. The questions include the following; (1) At what time traction should be applied and till when it should be continued? (2) What are the indications of taking anterior, posterior, or combined corridors?…”

Section: Discussionmentioning

confidence: 99%

“…Cervical spondyloptosis typically results from severe hyperextension or hyperflexion-compression injury with bilateral pedicle fractures, and bilateral locked facets, with or without fracture of the laminae. 1 These injuries are usually associated with complete and irreversible spinal cord injury. Sometimes fracture of the posterior elements can lead to a spontaneous decompression of the spinal canal and thereby preserve the spinal cord by the cord moving posterior.…”

Section: Discussionmentioning

confidence: 99%

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Anterior-Only Approach for Posttraumatic Subaxial Cervical Spine Spondyloptosis: A Case Report and Review of Literature

Kumar

Singh

Das

et al. 2019

IJNS

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Subaxial posttraumatic spondyloptosis is a rare entity with management dilemma in the literature. Various approaches have been discussed, but few reports focused on management plan and rationale. The authors reviewed the literature and reported a case of a 30-year-old woman presented with posttraumatic spastic quadriparesis. The patient had C6–7 spondyloptosis and was operated by anterior-only approach. There was improvement in both motor and sensory neurologic status. Surgical goals include vertebral realignment and stabilization. The authors conclude that anterior approach may be good enough if performed properly even if all three columns are involved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Anterior-Only Approach for Posttraumatic Subaxial Cervical Spine Spondyloptosis: A Case Report and Review of Literature

Kumar

Singh

Das

et al. 2019

IJNS

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“…There is a significant rupture of the ligaments in the extreme spondylolisthesis which may be associated with fractures of the lateral masses, laminae, pedicles or/and vertebral bodies. The enlargement of the spinal canal that causes these associated fractures has been considered the principal reason of absence of neurological deficits in previous publications (7,13,14).…”

Section: Discussionmentioning

confidence: 99%

“…The most accepted approach is the combined anterior and posterior 360º or 540º, with or without corpectomies. This approach provides wide canal decompression and successful cervical spine realignment (1)(2)(3)(4)(5)(6)(7)(10)(11)(12)(13). Additionally, the management of chronic spondylisthesis would have some considerations according to our experience.…”

Section: Discussionmentioning

confidence: 99%

“…The initial management of these fractures is generally a cervical traction to achieve a closed reduction that may allow a subsequent spinal stabilization with an anterior, posterior or combined approach (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). Nevertheless, in the chronic spondyloptosis (4) or high grade spondylolisthesis the treatment of the patient became a challenge to achieve a correct spinal alignment avoiding the worsening of the neurological status.…”

Section: Case Reportmentioning

confidence: 99%

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Treatment of chronic traumatic C7–T1 grade III spondylolisthesis with mild neurological deficit: case report

et al. 2017

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Traumatic cervical severe spondylolisthesis is a rare and severe lesion which is typically associated with a spinal cord injury. Nevertheless, it occasionally has a pauci-symptomatic course which may delay its diagnosis. The authors report an exceptional case of a 33-year-old woman who had mild spasticity in her lower limbs and neck pain 9 months after a traffic accident. The computed tomographic scan and magnetic resonance image revealed C7-T1 grade III spondylolisthesis and spinal cord signal change. The initial cervical traction did not obtain a spinal realignment. An anterior-posterior approach was performed to achieve a correct spinal fusion. After 18 months of follow-up care, the patient's symptoms improved significantly and she began to lead a normal life again. The case underlines the importance of performing a correct initial diagnostic workup upon a patient. This would improve surgical management by avoiding a worsening of the initial neurological deficit during the realignment maneuvers in the chronic grade III, IV or V spondylolisthesis. Case ReportTraumatic subaxial cervical luxations are typically produced by high-energy mechanisms and are associated with major spinal cord injury and mechanical instability. Cervicothoracic spondyloptosis or severe spondylolisthesis is an especially severe injury, usually with an easy diagnosis in the initial evaluation of a traumatic patient. Although there are cases reported of neurologically intact patients, the delay in the diagnosis is extremely rare (1,2). We present a case of a C7-T1 grade III spondylolisthesis identified 9 months after the traumatic event with mild progressive pyramidal symptoms in the lower limbs.The initial management of these fractures is generally a cervical traction to achieve a closed reduction that may allow a subsequent spinal stabilization with an anterior, posterior or combined approach (1-12). Nevertheless, in the chronic spondyloptosis (4) or high grade spondylolisthesis the treatment of the patient became a challenge to achieve a correct spinal alignment avoiding the worsening of the neurological status. Case presentationA 33-year-old female, without other medical pathologies or neurological damages, was admitted to the emergency room after a road traffic collision. The initial neurological examination was normal. The cervical spine plain radiography, in which the cervicothoracic union was not well defined, was considered normal (Figure 1). The patient was discharged with mild cervical pain. The pain remained approximately 8 weeks after the accident but no more radiological exams were made. Progressive subjective mild motor weakness and numbness of the lower limbs appeared progressively six-seven later. Nine months after the accident she was evaluated by a neurologist. The J Spine Surg 2017;3(1):82-86 jss.amegroups.com exploration revealed brisk reflexes in her lower limbs and decreased sensation at level at C7; there were no objective motor deficits (ASIA score D). The cervicothoracic MRI and CT (Figures 2,3) showed a C7-T1 tr...

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Subaxial Cervical Trauma

Maduri

Duff

2019

Spine Surgery

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Traumatic spondylolisthesis and spondyloptosis of the subaxial cervical spine without neurological deficits: closed re-alignment, surgical options and literature review

Cited by 26 publications

References 22 publications

Anterior-Only Approach for Posttraumatic Subaxial Cervical Spine Spondyloptosis: A Case Report and Review of Literature

Anterior-Only Approach for Posttraumatic Subaxial Cervical Spine Spondyloptosis: A Case Report and Review of Literature

Treatment of chronic traumatic C7–T1 grade III spondylolisthesis with mild neurological deficit: case report

Subaxial Cervical Trauma

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