Skip to main content
Top
Published in: International Orthopaedics 11/2011

01-11-2011 | Original Paper

Unusual traumatic spondyloptosis causing complete transaction of spinal cord

Authors: S. H. Chandrashekhara, A. Kumar, S. Gamanagatti, K. Kapoor, A. Mukund, D. Aggarwal, S. Sinha

Published in: International Orthopaedics | Issue 11/2011

Login to get access

Abstract

Background

Traumatic spondyloptosis is defined as greater than 100% of traumatic subluxation of one vertebral body in the coronal or sagittal plane which usually causes the complete transaction of spinal cord. It is a rare but severe injury of the vertebral column. We present four unusual cases of traumatic spondyloptosis causing complete spinal cord transaction, which were operated upon successfully.

Methods

We reviewed the imaging findings of four patients with traumatic thoraco-lumbar spondyloptosis from our radiology database, who presented to our trauma centre from August 2008 to September 2008. Four patients were identified with ages ranging from ten to 27 years. All patients had sustained high-energy closed spinal injuries. All patients underwent plain radiography, CT and MR imaging.

Results

Three patients had sagittal plane spondyloptosis and one patient had coronal plane spondyloptosis. Complete cord/cauda eqina transection was present in all patients. One patient had low lying cord with complete cord transection. All patients underwent surgery. Reduction of displacement with pedicle screw and rod fixation was carried out to realign the vertebral column. None of the patients recovered neurological function postoperatively.

Conclusions

To conclude, traumatic thoraco-lumbar spondyloptosis is very rare and radiology plays an important role in the diagnosis and management of traumatic spondyloptosis. Surgical reconstruction and stabilisation allows for rehabilitation.
Literature
1.
go back to reference Bellew MP, Bartholomew BJ (2007) Dramatic neurological recovery with delayed correction of traumatic lumbar spondyloptosis. Case report and review of the literature. J Neurosurg Spine 6(6):606–610PubMedCrossRef Bellew MP, Bartholomew BJ (2007) Dramatic neurological recovery with delayed correction of traumatic lumbar spondyloptosis. Case report and review of the literature. J Neurosurg Spine 6(6):606–610PubMedCrossRef
2.
3.
go back to reference Chul Woo Lee, Sun Chul Hwang, Soo Bin Im, Bun Tae Kim, Won Han Shin (2004) Traumatic thoracic spondyloptosis: a case report. J Korean Neurosurg Soc 622–624 Chul Woo Lee, Sun Chul Hwang, Soo Bin Im, Bun Tae Kim, Won Han Shin (2004) Traumatic thoracic spondyloptosis: a case report. J Korean Neurosurg Soc 622–624
4.
go back to reference Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8:817–831PubMedCrossRef Denis F (1983) The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine 8:817–831PubMedCrossRef
5.
go back to reference Denis F, Burkus JK (1992) Shear fracture-dislocations of the thoracic and lumbar spine associated with forceful hyperextension (lumberjack paraplegia). Spine 17:156–161PubMedCrossRef Denis F, Burkus JK (1992) Shear fracture-dislocations of the thoracic and lumbar spine associated with forceful hyperextension (lumberjack paraplegia). Spine 17:156–161PubMedCrossRef
6.
go back to reference El-Khoury GY, Whitten CG (1993) Trauma to the upper thoracic spine: anatomy, biomechanics and unique imaging features. Am J Roentgenol 160:95–102 El-Khoury GY, Whitten CG (1993) Trauma to the upper thoracic spine: anatomy, biomechanics and unique imaging features. Am J Roentgenol 160:95–102
7.
go back to reference Han IH, Song GS (2002) Thoracic pedicle screw fixation and fusion in unstable thoracic spine fractures. J Korean Neurosurg Soc 32:334–340 Han IH, Song GS (2002) Thoracic pedicle screw fixation and fusion in unstable thoracic spine fractures. J Korean Neurosurg Soc 32:334–340
8.
go back to reference Hanley EN Jr, Knox BD, Ramasastry S, Moossy JJ (1993) Traumatic lumbopelvic spondyloptosis. A case report. J Bone Joint Surg Am 75(11):1695–1698PubMed Hanley EN Jr, Knox BD, Ramasastry S, Moossy JJ (1993) Traumatic lumbopelvic spondyloptosis. A case report. J Bone Joint Surg Am 75(11):1695–1698PubMed
9.
go back to reference Meneghini RM, DeWald CJ (2003) Traumatic posterior spondyloptosis at the lumbosacral junction. A case report. J Bone Joint Surg Am 85-A(2):346–350PubMed Meneghini RM, DeWald CJ (2003) Traumatic posterior spondyloptosis at the lumbosacral junction. A case report. J Bone Joint Surg Am 85-A(2):346–350PubMed
10.
go back to reference Park YK, Lee JK, Lim DJ, Chung HS, Lee HK (1999) Pedicle screw fixation of the thoracic spine. J Korean Neurosurg Soc 28:190–195 Park YK, Lee JK, Lim DJ, Chung HS, Lee HK (1999) Pedicle screw fixation of the thoracic spine. J Korean Neurosurg Soc 28:190–195
11.
go back to reference Yadla S, Lebude B, Tender GC, Sharan AD, Harrop JS, Hilibrand AS, Vaccaro AR, Ratliff JK (2008) Traumatic spondyloptosis of the thoracolumbar spine. J Neurosurg Spine 9(2):145–151PubMedCrossRef Yadla S, Lebude B, Tender GC, Sharan AD, Harrop JS, Hilibrand AS, Vaccaro AR, Ratliff JK (2008) Traumatic spondyloptosis of the thoracolumbar spine. J Neurosurg Spine 9(2):145–151PubMedCrossRef
Metadata
Title
Unusual traumatic spondyloptosis causing complete transaction of spinal cord
Authors
S. H. Chandrashekhara
A. Kumar
S. Gamanagatti
K. Kapoor
A. Mukund
D. Aggarwal
S. Sinha
Publication date
01-11-2011
Publisher
Springer-Verlag
Published in
International Orthopaedics / Issue 11/2011
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-010-1190-6

Other articles of this Issue 11/2011

International Orthopaedics 11/2011 Go to the issue