Case Reports
Traumatic Thoracic Spondyloptosis Without Neurologic Deficit, and Treatment With In Situ Fusion
Am J Orthop. 2009 October;38(10):E162-E165
Author and Disclosure Information
Alex Gitelman, MD, Matthew J. Most, MD, and Mark Stephen, MD
Dr. Gitelman is Spine Surgery Fellow, University of California Los Angeles Comprehensive Spine Center, Santa Monica, California. He was resident, Department of Orthopaedic Surgery, Stony Brook University Medical Center, Stony Brook, New York, at the time the article was written.
Dr. Most is Assistant Professor and Chief, Division of Orthopaedic Oncology, Department of Orthopaedics and Rehabilitation, University of Massachusetts Memorial Medical Center, Worcester, Massachusetts.
Dr. Stephen is Chief of Spine Surgery, Department of Orthopaedic Surgery, Stony Brook University Medical Center, Stony Brook, New York.
Abstract not available. Introduction provided instead.
Thoracic spinal fracture-disassociation (traumatic spondyloptosis) is a rare injury caused by high-energy forces. This injury most often leaves the patient with a severe neurologic deficit. Complete paraplegia is estimated to result in up to 80% of cases.1 In this article, we report the case of a patient who presented with a complete traumatic thoracic spondyloptosis but no neurologic deficits. He was treated surgically, with posterior instrumented spinal fusion in situ. Given the patient’s spinal canal preservation and overall spinal alignment, reduction was not attempted. The postoperative course was complicated only by a wound infection, at 14 months, when already there was clinical and radiographic evidence of solid fusion. The infection was treated successfully with irrigation and débridement, implant removal, and intravenous (IV) antibiotics. At most recent (30-month) follow-up, the patient was neurologically intact and independently ambulating.