Intraoperative Closed Reduction of Traumatic Lateraloptosis: Operative Nuances

Area of Science:

• Spinal surgery
• Orthopedic trauma
• Neurosurgery

Background:

• Traumatic lateral spondyloptosis (lateraloptosis) involves complete lateral spinal dislocation.
• Reduction presents challenges, particularly with preserved neurological function.
• Open reduction risks include CSF leak and neurological injury; off-table techniques risk reduction loss.

Purpose of the Study:

• To describe an on-table closed reduction technique for lateraloptosis.
• To compare this technique with existing open and off-table methods.
• To evaluate the efficacy and safety of the on-table closed reduction.

Main Methods:

• An illustrative case of lateraloptosis treated with on-table closed reduction is presented.
• The technique was compared with literature-described open and off-table reduction methods.
• Patient outcomes were assessed for mechanical and neurological function.

Main Results:

• The described on-table closed reduction technique was successfully applied.
• The patient achieved good mechanical and neurological outcomes.
• At 14 months postoperatively, the patient was neurologically intact, returned to heavy lifting, with moderate pain.

Conclusions:

• On-table closed reduction before open fixation is a viable option for lateraloptosis.
• This technique is particularly recommended for cases with preserved neurological function.
• It offers potential advantages over traditional open or off-table reduction methods.