Dramatic neurological recovery with delayed correction of traumatic lumbar spondyloptosis. Case report and review of the literature.
The authors describe a 36-year-old woman with traumatic lateral spondyloptosis at L-2 and complete cauda equina injury who experienced a remarkable recovery after delayed treatment. To the authors' knowledge, this is the first case of traumatic spondyloptosis at L2-3 described in the English literature. A review of previous cases of lumbar spondyloptosis suggests that the degree of anatomical injury found at surgery is a better predictor of patient outcome than fracture severity assessed radiologically. Concomitant multisystem injury is common with spine disruptions of this magnitude and may mask clinical neurological function. Even when delayed, operative decompression of these severe lesions should be considered because dramatic neurological recovery is possible.
Bellew
Michael P
MP
Department of Neurosurgery, Tulane University, New Orleans, Louisiana, USA. mbellew@mac.com
Bartholomew
Bradley J
BJ
D000063:Accidents, Traffic; D000328:Adult; D002420:Cauda Equina / Q000293:injuries*; D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae; D009420:Nervous System / Q000503:physiopathology*; D020127:Recovery of Function; D013123:Spinal Fusion; D013168:Spondylolisthesis / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000209:etiology