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Management of traumatic cervical spondyloptosis in a neurologically intact patient: case report.
Spine (Phila Pa 1976) 2009; 34(19):E703-8S

Abstract

STUDY DESIGN

Case report.

OBJECTIVE

To review the management of a neurologically intact patient with complete cervical spondyloptosis with particular attention to the role and timing of closed preoperative cervical traction and subsequent stabilization.

SUMMARY OF BACKGROUND DATA

Traumatic cervical spondyloptosis is typically associated with complete and irreversible spinal cord injury. In these patients, cervical traction can be implemented to restore anatomic alignment in preparation for stabilization with minimal consequence. When a patient presents neurologically intact, the management becomes more complicated. Preservation of function and restoration of anatomic alignment collectively represent the goals of therapy. The current literature does not clearly define the role of cervical traction in such cases.

METHODS

A patient with traumatic cervical spondyloptosis at the C7-T1 level presented to our institution and was found to be neurologically intact. Computed tomography demonstrated complete spondyloptosis with multiple fractures through the posterior elements.

RESULTS

The spondyloptosis was reduced with closed cervical traction and underwent anterior and posterior instrumented stabilization. No new deficit occurred in the patient after reduction.

CONCLUSION

Fractures of the posterior elements functionally decompress the spinal canal and thereby allow for cervical traction to be safely implemented in patients with spondyloptosis. Safe restoration of anatomic alignment in the neurologically intact spondyloptotic patient is crucial to minimize the extent of surgical stabilization and create a long-term stable construct of the fracture dislocation.

Authors+Show Affiliations

Department of Neurosurgery, Grady Memorial Hospital, Emory University School of Medicine, Atlanta, GA, USA. luis.tumialan@med.navy.milNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

19730203

Citation

Tumialán, Luis M., et al. "Management of Traumatic Cervical Spondyloptosis in a Neurologically Intact Patient: Case Report." Spine, vol. 34, no. 19, 2009, pp. E703-8.
Tumialán LM, Dadashev V, Laborde DV, et al. Management of traumatic cervical spondyloptosis in a neurologically intact patient: case report. Spine. 2009;34(19):E703-8.
Tumialán, L. M., Dadashev, V., Laborde, D. V., & Gupta, S. K. (2009). Management of traumatic cervical spondyloptosis in a neurologically intact patient: case report. Spine, 34(19), pp. E703-8. doi:10.1097/BRS.0b013e3181b1fc3a.
Tumialán LM, et al. Management of Traumatic Cervical Spondyloptosis in a Neurologically Intact Patient: Case Report. Spine. 2009 Sep 1;34(19):E703-8. PubMed PMID: 19730203.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of traumatic cervical spondyloptosis in a neurologically intact patient: case report. AU - Tumialán,Luis M, AU - Dadashev,Vladimir, AU - Laborde,David V, AU - Gupta,Sanjay K, PY - 2009/9/5/entrez PY - 2009/9/5/pubmed PY - 2009/11/13/medline SP - E703 EP - 8 JF - Spine JO - Spine VL - 34 IS - 19 N2 - STUDY DESIGN: Case report. OBJECTIVE: To review the management of a neurologically intact patient with complete cervical spondyloptosis with particular attention to the role and timing of closed preoperative cervical traction and subsequent stabilization. SUMMARY OF BACKGROUND DATA: Traumatic cervical spondyloptosis is typically associated with complete and irreversible spinal cord injury. In these patients, cervical traction can be implemented to restore anatomic alignment in preparation for stabilization with minimal consequence. When a patient presents neurologically intact, the management becomes more complicated. Preservation of function and restoration of anatomic alignment collectively represent the goals of therapy. The current literature does not clearly define the role of cervical traction in such cases. METHODS: A patient with traumatic cervical spondyloptosis at the C7-T1 level presented to our institution and was found to be neurologically intact. Computed tomography demonstrated complete spondyloptosis with multiple fractures through the posterior elements. RESULTS: The spondyloptosis was reduced with closed cervical traction and underwent anterior and posterior instrumented stabilization. No new deficit occurred in the patient after reduction. CONCLUSION: Fractures of the posterior elements functionally decompress the spinal canal and thereby allow for cervical traction to be safely implemented in patients with spondyloptosis. Safe restoration of anatomic alignment in the neurologically intact spondyloptotic patient is crucial to minimize the extent of surgical stabilization and create a long-term stable construct of the fracture dislocation. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/19730203/Management_of_traumatic_cervical_spondyloptosis_in_a_neurologically_intact_patient:_case_report_ L2 - http://Insights.ovid.com/pubmed?pmid=19730203 DB - PRIME DP - Unbound Medicine ER -