Results Of Single Stage Posterior Instrumentation In Complete Traumatic Spondyloptosis Of Thoracolumbar Spine
Abstract
Background: Complete traumatic spinal dislocations above lumbosacral junction are extremely rare injuries. These usually present with complete neural deficit below the level of injury. We present a short series of five patients of such unusual cases of traumatic spondyloptosis who presented to our hospital and were treated with single stage posterior instrumentation.
Material & methods: All patients with traumatic spinal injury with complete fracture dislocation i.e. more than 100% subluxation of one vertebra over the other treated with single stage posterior instrumentation were included in the study. Patients were assessed for the neural and bladder recovery, alignment of spinal column, implant loosening, rehabilitation and presence of bedsore.
Result: Five patients with mean age 31 years (range 22 to 36 years) and mean follow-up 14 months (range 12 to 18 months) were included in the study. All patients had with complete neurological deficit at the time of injury and none of patients neural power improved even at final follow-up. None of the patients had any bed sore present. All patients were mobile with the help of brace and wheel chair doning self- intermittent catheterization themselves. Radiologically, in all the patients the spinal column was well aligned, without any loss of alignment or fixation failure.
Conclusion: Traumatic spondyloptosis is an extremely rare severe form on spinal injury presenting with complete neurological deficit. Surgical management by posterior approach is aimed to realign the vertebral column with for proper rehabilitation of patient. Though one cannot expect neurological recovery in these patients but still early restoration of normal spinal cord anatomy should be done to provide proper milieu to the spinal cord and for early rehabilitation to the patient.
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