Rezaee H, Abouie-Mehriz M A, Mohazzab-Torabi S, Keykhosravi E. Post-traumatic Cervical Spondyloptosis Without Neurological Deficits: A Case Report. Iran J Neurosurg 2021; 7 (3) :165-170
URL:
http://irjns.org/article-1-272-en.html
1- Department of Neurosurgery, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran
2- Department of Neurosurgery, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, Iran , keykhosravie@mums.ac.ir
Abstract: (1835 Views)
Background and Importance: Traumatic cervical spondyloptosis is a rare and severe situation, i.e., associated with disabling neurological deficits.
Case Presentation: We described an unusual clinical presentation of cervical spondyloptosis in a 49-year-old man without neurological impairment and severe neck pain. Moreover, C6-C7 spondyloptosis was assessed two days after the trauma. X-rays, Computed Tomography (CT) scans and Magnetic Resonance Imaging (MRI) demonstrated a C6 bi-pedicular fracture, C6-C7 facet dislocation with complete ptosis of C6 vertebral body over C7 and without spinal cord injury. The patient was managed with an intra-operative 4 Kg traction and underwent a posterior decompression, with reduced fracture/dislocation by bilateral completed facetectomies at C6, and fusion from C4 to T3.
Conclusion: This case report emphasized that sometimes cervical spondyloptosis may occur without neurological deficit symptoms. Prompt clinical recognition and surgical removal are essential to prevent serious complications in this respect.
Full Text [PDF 667 kb]
(689 Downloads)
| |
Full Text (HTML) (1009 Views)
● Traumatic Cervical spondyloptosis without neurological deficit was successfully treated with combined approach.
● Novel anterior/posterior approach is important for correcting C6-C7 spondyloptosis.
Plain Language Summary
Traumatic spinal injury due to its catastrophic outcomes has a mountable effect on the patient’s quality of life and burden of diseases. Many of these kinds of trauma are related to spinal fractures which are often related to neurological deficits such as complete or incomplete spinal cord injuries. Interestingly, we reported a refereed patient from a port-town city in Iran with a history of motor vehicle accidents who was diagnosed with complete cervical C6-C7 dislocation. Although studies show that this kind of fracture often manifests with a new neurological problem, our patient presented no neurological deficit. Complete cervical dislocation is the required emergency surgical treatment, which is anterior or posterior cervical fixation. Gardner traction was applied for the patient with gradual increasing weight to achieve optimal reduction. Then, the patient underwent posterior fixation followed by anterior Cervical discectomy and fusion to achieve 360 degrees fixation.
Type of Study:
Case report |
Subject:
Spine