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Management of traumatic double-level spondyloptosis of the thoracic spine with posterior spondylectomy: case report.
J Neurosurg Spine 2015; 23(6):715-20JN

Abstract

Traumatic spondyloptosis of the thoracic spine is an uncommon injury. In most cases, spondyloptosis is confined to one vertebral body, whereas double-level spondyloptosis is extremely rare. Most patients who sustain traumatic spondyloptosis immediately become paraplegic, but in some cases neurological function is preserved. If this occurs, it is due to detachment of the pedicles from the corresponding vertebral body, resulting in spontaneous decompression of neural elements. Herein, the authors describe a case of undetected traumatic double-level spondyloptosis in the upper thoracic region in an adult male patient who was neurologically intact for 2 days but later became paraplegic. Initially, management of this pathology seemed a very challenging scenario. However, with review of the reconstructed CT images and reproduction of the injury on a plastic model, a posterior-only approach was chosen as an alternative operative solution for this catastrophic injury. Via this single-stage posterior approach, long-segment pedicle screw/rod instrumentation resulted in successful reduction, restoration of alignment, and stabilization after 1-level posterior spondylectomy. To the best of the authors' knowledge, this is the first example reported in the literature of double-level spondyloptosis of the thoracic and the lumbar spine. This report describes the rationale, mechanism, and technical details afforded for reduction and stabilization of this rare injury.

Authors+Show Affiliations

Department of Neurosurgery, Pars Advanced & Minimally Invasive Manners Research Center, Pars Hospital, Iran University of Medical Sciences, Tehran, Iran; and.University of Birmingham, United Kingdom.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

26296192

Citation

Rahimizadeh, Abolfazl, and Ava Rahimizadeh. "Management of Traumatic Double-level Spondyloptosis of the Thoracic Spine With Posterior Spondylectomy: Case Report." Journal of Neurosurgery. Spine, vol. 23, no. 6, 2015, pp. 715-20.
Rahimizadeh A, Rahimizadeh A. Management of traumatic double-level spondyloptosis of the thoracic spine with posterior spondylectomy: case report. J Neurosurg Spine. 2015;23(6):715-20.
Rahimizadeh, A., & Rahimizadeh, A. (2015). Management of traumatic double-level spondyloptosis of the thoracic spine with posterior spondylectomy: case report. Journal of Neurosurgery. Spine, 23(6), pp. 715-20. doi:10.3171/2015.3.SPINE14183.
Rahimizadeh A, Rahimizadeh A. Management of Traumatic Double-level Spondyloptosis of the Thoracic Spine With Posterior Spondylectomy: Case Report. J Neurosurg Spine. 2015;23(6):715-20. PubMed PMID: 26296192.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Management of traumatic double-level spondyloptosis of the thoracic spine with posterior spondylectomy: case report. AU - Rahimizadeh,Abolfazl, AU - Rahimizadeh,Ava, Y1 - 2015/08/21/ PY - 2015/8/22/entrez PY - 2015/8/22/pubmed PY - 2016/4/8/medline KW - spinal trauma KW - spine shortening KW - spondylectomy KW - spondyloptosis KW - thoracic fracture KW - vertebral column resection KW - vertebrectomy SP - 715 EP - 20 JF - Journal of neurosurgery. Spine JO - J Neurosurg Spine VL - 23 IS - 6 N2 - Traumatic spondyloptosis of the thoracic spine is an uncommon injury. In most cases, spondyloptosis is confined to one vertebral body, whereas double-level spondyloptosis is extremely rare. Most patients who sustain traumatic spondyloptosis immediately become paraplegic, but in some cases neurological function is preserved. If this occurs, it is due to detachment of the pedicles from the corresponding vertebral body, resulting in spontaneous decompression of neural elements. Herein, the authors describe a case of undetected traumatic double-level spondyloptosis in the upper thoracic region in an adult male patient who was neurologically intact for 2 days but later became paraplegic. Initially, management of this pathology seemed a very challenging scenario. However, with review of the reconstructed CT images and reproduction of the injury on a plastic model, a posterior-only approach was chosen as an alternative operative solution for this catastrophic injury. Via this single-stage posterior approach, long-segment pedicle screw/rod instrumentation resulted in successful reduction, restoration of alignment, and stabilization after 1-level posterior spondylectomy. To the best of the authors' knowledge, this is the first example reported in the literature of double-level spondyloptosis of the thoracic and the lumbar spine. This report describes the rationale, mechanism, and technical details afforded for reduction and stabilization of this rare injury. SN - 1547-5646 UR - https://www.unboundmedicine.com/medline/citation/26296192/Management_of_traumatic_double_level_spondyloptosis_of_the_thoracic_spine_with_posterior_spondylectomy:_case_report_ L2 - https://medlineplus.gov/spineinjuriesanddisorders.html DB - PRIME DP - Unbound Medicine ER -