title: Post-traumatic cervical spondyloptosis: A rare entity with multiple management options.
abstract: Post-traumatic cervical spondyloptosis is a rare condition associated with high energy injuries, and to our knowledge only case reports are available. There are no universally accepted treatment paradigms for these cases and management is individualised according to the case and surgeon preference. We retrospectively analysed our management and clinical outcomes of this condition. From January 2007 to August 2014 we treated eight patients with cervical spondyloptosis at our institute. Only two patients had no neurological deficits; all the remaining patients had partial cord injury. Seven were treated surgically with preoperative traction followed by anterior cervical discectomy and fusion with fixation in three patients, and combined anterior and posterior fusion and fixation in four. Depending on the presence of anterior compression by a disc an anterior first or posterior first approach was advocated. All four combined anterior and posterior fusion and fixation patients needed to be turned more than once (540°). There was no neurological deterioration in any of the patients, as they either improved or remained stable neurologically. Post-traumatic cervical spondyloptosis is a challenging entity to manage. Surgery can be done safely with good clinical and radiological outcome and needs to be tailored to the individual patient.
authors.affiliation: Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India.
authors.forename: A
authors.initials: A
authors.lastname: Padwal
authors.affiliation: Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India.
authors.forename: D
authors.initials: D
authors.lastname: Shukla
authors.affiliation: Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India. Electronic address: dibhat@rediffmail.com.
authors.forename: D I
authors.initials: DI
authors.lastname: Bhat
authors.affiliation: Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India.
authors.forename: S
authors.initials: S
authors.lastname: Somanna
authors.affiliation: Department of Neurosurgery, NIMHANS, Hosur Road/Marigowda Road, Bangalore 560029, India.
authors.forename: B I
authors.initials: BI
authors.lastname: Devi
mesh_terms: D000328:Adult; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D012189:Retrospective Studies; D013119:Spinal Cord Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D013124:Spinal Injuries / Q000000981:diagnostic imaging / Q000601:surgery; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anterior fixation; Cervical; Facet locking; Posterior fixation; Spine injury; Spondyloptosis