Document Detail


C4-5 post-traumatic spondyloptosis with in-situ fusion: Systematic literature review and case report.
MedLine Citation:
PMID:  23380823     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
ABSTRACT:: Study design:A case report with systematic review of the literature.Objective:To report a case of posttraumatic C4-5 spondyloptosis without neurological deficit not associated with posterior element fractures and presenting in a delayed fashion with fusion in situ of C4 and C5 vertebral bodies influencing the management strategy.Summary of Background Data: Traumatic spondyloptosis of the subaxial cervical spine is typically associated with neurological injury. To the best of the author's knowledge this is the first case of spondyloptosis not associated with fractures of the posterior elements but with locked facets at C4-5 and fusion in situ, presenting in a delayed fashion with remarkable paucity of symptoms that was managed surgically.Methods: A 45-year-old man status post motor vehicle collision presented 8 months after injury with radicular arm pain and mild spasticity involving the legs. Cervical Xray, CT and MRI revealed bilateral locked facets at C4-5 with spondyloptosis. Fusion had occurred in situ.Results: Traction did not correct alignment and the patient underwent circumferential reduction and fusion and postoperative halo-vest placement. At six months follow-up, the patient remained neurologically intact with regression of preoperative symptoms.Conclusions: Longstanding posttraumatic spondyloptosis may lead to fusion in situ complicating the surgical management. Insufficient suspicion during workup can lead to the omission of this important diagnosis, further complicating operative intervention. Traction is not useful when in-situ fusion has occurred in delayed presentation cases.
Authors:
Jaime Gasco; Daniel J Dilorenzo; Joel T Patterson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-2-1
Journal Detail:
Title:  Spine     Volume:  -     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-2-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1Division of Neurosurgery, University of Texas Medical Branch, Galveston, TX, USA 2Department of Neurosurgery, Rush University, Chicago, IL, USA.
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