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Spontaneous Fusion of S2/S3 Spondyloptosis in an Adult
Payman Vahedi1, George N Rymarczuk2, John L Gillick3
1Department of Neurological Surgery, Thomas Jefferson University, Philadelphia, Pennsylvania, USA; Department of Neurosurgery, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
Background:
Spondyloptosis is grade V on the Meyerding classification. Traumatic spondyloptosis can occur throughout the spinal column, particularly at junctional levels, and finding an ideal surgical strategy to address it remains a challenge for spinal surgeons. The sacrum is considered a united bone in adults, and sacral intersegmental spondyloptosis is extremely rare.
Case Report:
Herein, we present an unusual case of S2/S3 spondyloptosis in a 27-year-old female patient with spontaneous solid fusion.
Conclusions:
This case demonstrates that similar distal sacral pathologies may be managed conservatively when there is no associated neurologic deficit, and the osteodiskoligamentous integrity of the lumbosacropelvic unit remains intact. Our report plus the very few published papers in the literature illustrate the natural history of uncomplicated traumatic spondyloptosis and support the role of in situ fusion and instrumentation as a reliable alternative to circumferential fusion in patients who cannot tolerate staged or prolonged operations.
