Unusual traumatic spondyloptosis causing complete transection of spinal cord

Traumatic spondyloptosis is defined as greater than 100% of traumatic subluxation of one vertebral body in the coronal or sagittal plane which usually causes the complete transaction of spinal cord. It is a rare but severe injury of the vertebral column. We present four unusual cases of traumatic spondyloptosis causing complete spinal cord transaction, which were operated upon successfully.

We reviewed the imaging findings of four patients with traumatic thoraco-lumbar spondyloptosis from our radiology database, who presented to our trauma centre from August 2008 to September 2008. Four patients were identified with ages ranging from ten to 27 years. All patients had sustained high-energy closed spinal injuries. All patients underwent plain radiography, CT and MR imaging.

Three patients had sagittal plane spondyloptosis and one patient had coronal plane spondyloptosis. Complete cord/cauda eqina transection was present in all patients. One patient had low lying cord with complete cord transection. All patients underwent surgery. Reduction of displacement with pedicle screw and rod fixation was carried out to realign the vertebral column. None of the patients recovered neurological function postoperatively.

To conclude, traumatic thoraco-lumbar spondyloptosis is very rare and radiology plays an important role in the diagnosis and management of traumatic spondyloptosis. Surgical reconstruction and stabilisation allows for rehabilitation.