J Korean Neurosurg Soc.  2013 Jan;53(1):49-51. 10.3340/jkns.2013.53.1.49.

The Surgical Management of Traumatic C6-C7 Spondyloptosis

• Keskin F
• Kalkan E
• Erdi F

• KMID: 2066986
• DOI: http://doi.org/10.3340/jkns.2013.53.1.49

Abstract

A case of traumatic spondyloptosis of the cervical spine at the C6-C7 level is reported. The patient was treated succesfully with a anterior-posterior combined approach and decompression. The patient had good neurological outcome after surgery. A-51-year-old female patient was transported to our hospital's emergency department after a vehicle accident. The patient was quadriparetic (Asia D, MRC power 4/5) with severe neck pain. Plain radiographs, computerize tomography and spinal magnetic resonance imaging (MRI) showed C6-7 spondyloptosis and C5, C6 posterior element fractures. Gardner-Wells skeleton traction was applied. Spinal alignment was reachived by traction and dislocation was decreased to a grade 1 spondylolisthesis. Then the patient was firstly operated by anterior approach. Anterior stabilization and fusion was firstly achieved. Seven days after first operation the patient was operated by a posterior approach. The posterior stabilization and fusion was achieved. Postoperative lateral X-rays and three-dimensional computed tomography showed the physiological realignment and the correct screw placements. The patient's quadriparesis was improved significantly. Subaxial cervical spondyloptosis is a relatively rare clinical entity. In this report we present a summary of the clinical presentation, the surgical technique and outcome of this rarely seen spinal disorder.

Keyword

Cervical spondyloptosis; Spinal cord compression; Spinal stabilization

MeSH Terms

Decompression
Dislocations
Emergencies
Female
Humans
Magnetic Resonance Imaging
Neck Pain
Quadriplegia
Skeleton
Spinal Cord Compression
Spine
Spondylolisthesis
Traction

Figure

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  Fig. 1 Magnetic resonance imaging of the cervical spine reveals total spondyloptosis at the C6-C7 level. Note the large disc which causes compression and edema in the lower spinal cord.

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  Fig. 2 Post-operative plain radiograph of the cervical spine with physiological realignment and anterior and posterior stabilization.

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  Fig. 3 Post-operative three-dimensional reconstruction computed tomography scan of the cervical spine.

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