Traumatic spondyloptosis of the lumbar spine: a case report

Abstract

IntroductionSpondyloptosis is the most severe of translation spine injuries. It results in complete disruption of the structural elements of the vertebral column and the adjacent paravertebral soft tissues, culminating in severe biomechanical instability. Although several cases of lumbosacral spondyloptosis have been documented, not many cases of traumatic lumbar spondyloptosis have been published in the literature.Case presentationWe present a case of a 34-year-old man of Nilo-Hamitic ethnicity who presented to our unit with paraplegia following injury from the collapse of a concrete wall. Radiographic images showed spondyloptosis at the fourth lumbar vertebral level. He underwent surgery where decompression, reduction, posterior instrumentation and bone grafting through a posterior approach were done. He started regaining motor power 48 hours postoperatively. He is currently undergoing rehabilitation and is steadily improving, 2 months postoperatively.ConclusionsIn limited-resource settings there is a tendency of “skilful neglect” of complex injuries. Where resources allow, surgical reconstruction of spondyloptosis should be attempted irrespective of the severity of the initial neurological deficit because there are chances of neurological improvement.

Traumatic lumbar spondylolisthesis without facet fracture at L4/L5. A case report and literature review

“…Finally, surgical treatment was a L4-L5 laminectomy, cage, and fixation by four pedicular screws connected by two parallel rods. Open reduction and circumferential bony fusion restored segmental stability and painless function [13]. The patient was mobilized in an armchair after two days of a total resolution of the painful symptoms.…”

“…Meticulous clinical examination and careful imaging assessment, including CT scan and MRI, provide an early diagnosis in cases of lumbosacral dislocation [12]. MRI demonstrates a disruption of the posterior ligamentous [3,12,13]. Initially the treatment is conservative and involves hospitalization with bed rest and more analgesics; then surgical treatment is indicated.…”

Traumatic spondyloptosis of L3 with incomplete neurological involvement: A case report

“…Within the traumatic spine pathology, vertebral spondyloptosis corresponds to the maximum expression of instability. This is defined as subluxation of >100% of a vertebral body on another [2]. It is usually associated with a severe neurological deficit.…”

“…Spondyloptosis is a surgical challenge, depending on the complexity and high variability of the presentation in the spine. Surgical reconstruction provides the best outcome because it restores the stability of the spine and facilitates early rehabilitation [2]. Spine surgeons must adapt and solve this challenging scenario despite having no experience given the infrequency of this spinal trauma presentation.…”

Traumatic Lumbosacral Spondyloptosis in a Pediatric Patient: Case Report and Literature Review

“…Traumatic spondyloptosis is defined as ≥100% listhesis of adjoining vertebrae in the coronal or sagittal plane secondary to high-energy trauma [1, 2]. According to the AOspine fracture classification of lumbar spinal fracture, traumatic spondyloptosis is categorized as a type C fracture with severe biomechanical instability [3].…”