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Traumatic spondyloptosis: a series of 20 patients.
J Neurosurg Spine 2015; 22(6):647-52JN

Abstract

OBJECT Spondyloptosis represents the most severe form of spondylolisthesis, which usually follows high-energy trauma. Few reports exist on this specific condition, and the largest series published to date consists of only 5 patients. In the present study the authors report the clinical observations and outcomes in a cohort of 20 patients admitted to a regional trauma center for severe injuries including spondyloptosis.

METHODS

The authors performed a retrospective chart review of patients admitted with spondyloptosis at their department over a 5-year period (March 2008-March 2013). Clinical, radiological, and operative details were reviewed for all patients.

RESULTS

In total, 20 patients with spondyloptosis were treated during the period reviewed. The mean age of the patients was 27 years (range 12-45 years), and 17 patients were male (2 boys and 15 men) and 3 were women. Fall from height (45%) and road traffic accidents (35%) were the most common causes of the spinal injuries. The grading of the American Spinal Injury Association (ASIA) was used to assess the severity of spinal cord injury, which for all patients was ASIA Grade A at the time of admission. In 11 patients (55%), the thoracolumbar junction (T10-L2) was involved in the injury, followed by the dorsal region (T1-9) in 7 patients (35%); 1 patient (5%) had lumbar and 1 patient (5%) sacral spondyloptosis. In 19 patients (95%), spondyloptosis was treated surgically, involving the posterior route in all cases. In 7 patients (37%), corpectomy was performed. None of the patients showed improvement in neurological deficits. The mean follow-up length was 37.5 months (range 3-60 months), and 5 patients died in the follow-up period from complications due to formation of bedsores (decubitus ulcers).

CONCLUSIONS

To the authors' best knowledge, this study was the largest of its kind on traumatic spondyloptosis. Its results illustrate the challenges of treating patients with this condition. Despite deformity correction of the spine and early mobilization of patients, traumatic spondyloptosis led to high morbidity and mortality rates because the patients lacked access to rehabilitation facilities postoperatively.

Authors+Show Affiliations

Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Center, All India Institute of Medical Sciences, New Delhi, India.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

25768668

Citation

Mishra, Akash, et al. "Traumatic Spondyloptosis: a Series of 20 Patients." Journal of Neurosurgery. Spine, vol. 22, no. 6, 2015, pp. 647-52.
Mishra A, Agrawal D, Gupta D, et al. Traumatic spondyloptosis: a series of 20 patients. J Neurosurg Spine. 2015;22(6):647-52.
Mishra, A., Agrawal, D., Gupta, D., Sinha, S., Satyarthee, G. D., & Singh, P. K. (2015). Traumatic spondyloptosis: a series of 20 patients. Journal of Neurosurgery. Spine, 22(6), pp. 647-52. doi:10.3171/2014.10.SPINE1440.
Mishra A, et al. Traumatic Spondyloptosis: a Series of 20 Patients. J Neurosurg Spine. 2015;22(6):647-52. PubMed PMID: 25768668.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Traumatic spondyloptosis: a series of 20 patients. AU - Mishra,Akash, AU - Agrawal,Deepak, AU - Gupta,Deepak, AU - Sinha,Sumit, AU - Satyarthee,Guru D, AU - Singh,Pankaj K, Y1 - 2015/03/13/ PY - 2015/3/14/entrez PY - 2015/3/15/pubmed PY - 2015/8/15/medline KW - ASIA KW - ASIA = American Spinal Injury Association KW - TLICS = thoracolumbar injury classification and severity KW - TLICS score KW - complication KW - spinal cord injury KW - spinal disorders KW - spondyloptosis KW - surgery KW - trauma SP - 647 EP - 52 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 22 IS - 6 N2 - OBJECT Spondyloptosis represents the most severe form of spondylolisthesis, which usually follows high-energy trauma. Few reports exist on this specific condition, and the largest series published to date consists of only 5 patients. In the present study the authors report the clinical observations and outcomes in a cohort of 20 patients admitted to a regional trauma center for severe injuries including spondyloptosis. METHODS The authors performed a retrospective chart review of patients admitted with spondyloptosis at their department over a 5-year period (March 2008-March 2013). Clinical, radiological, and operative details were reviewed for all patients. RESULTS In total, 20 patients with spondyloptosis were treated during the period reviewed. The mean age of the patients was 27 years (range 12-45 years), and 17 patients were male (2 boys and 15 men) and 3 were women. Fall from height (45%) and road traffic accidents (35%) were the most common causes of the spinal injuries. The grading of the American Spinal Injury Association (ASIA) was used to assess the severity of spinal cord injury, which for all patients was ASIA Grade A at the time of admission. In 11 patients (55%), the thoracolumbar junction (T10-L2) was involved in the injury, followed by the dorsal region (T1-9) in 7 patients (35%); 1 patient (5%) had lumbar and 1 patient (5%) sacral spondyloptosis. In 19 patients (95%), spondyloptosis was treated surgically, involving the posterior route in all cases. In 7 patients (37%), corpectomy was performed. None of the patients showed improvement in neurological deficits. The mean follow-up length was 37.5 months (range 3-60 months), and 5 patients died in the follow-up period from complications due to formation of bedsores (decubitus ulcers). CONCLUSIONS To the authors' best knowledge, this study was the largest of its kind on traumatic spondyloptosis. Its results illustrate the challenges of treating patients with this condition. Despite deformity correction of the spine and early mobilization of patients, traumatic spondyloptosis led to high morbidity and mortality rates because the patients lacked access to rehabilitation facilities postoperatively. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/25768668/Traumatic_spondyloptosis:_a_series_of_20_patients_ L2 - https://thejns.org/doi/10.3171/2014.10.SPINE1440 DB - PRIME DP - Unbound Medicine ER -