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Progressively unstable c2 spondylolysis requiring spinal fusion: case report
Yusuke Nishimura1, Michael John Ellis, Jennifer Anderson
1Division of Neurosurgery, St. Michael's Hospital, University of Toronto.
Neurologia Medico-Chirurgica
|March 4, 2014
Summary
Cervical spondylolysis, a rare pars interarticularis defect, can cause significant instability. Anterior cervical discectomy and fusion effectively treated a C2 spondylolysis case, resolving pain and neurological symptoms.
Area of Science:
- Orthopedics
- Neurosurgery
- Spine Surgery
Background:
- Cervical spondylolysis is a rare condition involving a corticated cleft in the cervical spine's pars interarticularis.
- C2 spondylolysis, specifically, can lead to progressive instability and significant patient morbidity.
Observation:
- A case report details a 20-year-old female with C2 spondylolysis presenting with worsening neck pain and C2/3 instability documented on flexion-extension X-rays.
- The patient underwent successful C2/3 anterior cervical discectomy and fusion (ACDF) with an anterior cervical plate.
Findings:
- The patient experienced immediate resolution of neck pain post-surgery.
- One-year postoperative follow-up showed complete resolution of neurological symptoms.
- Literature review identified 24 previously reported cases of C2 spondylolysis.
Implications:
- Differentiating C2 spondylolysis from acute traumatic fractures like hangman's fracture is crucial for appropriate management.
- Assessing C2/3 instability and neurological deficits is paramount for treatment planning.
- ACDF with an anterior cervical plate offers a biomechanically sound, less invasive, and effective stabilization method for unstable C2 spondylolysis.
