Minimally Invasive In-situ Fixation for Complete Traumatic D7-8 Spondyloptosis with Intact Neurology

Complete traumatic dorsal spondyloptosis with no neurological involvement is so rare due to the inherent stability of the thoracic spine, that only 2 other cases are reported in literature. A 31-year male with history of fall, and normal neurological examination was noted to have grade 5 dislocation at D7-D8, with locking of D7-8 bodies and expanded canal due to pedicle fractures accommodating the displaced spinal cord. As the excessive manipulation to achieve reduction was deemed too risky to be worthy, it was decided to do in-situ fixation without reduction. This is probably the first ever minimally invasive surgery (MIS) of percutaneous pedicle screw fixation for such a case in the literature. Under O-arm navigation, pedicle screws were placed in D5,6,8,9&10, with D8 screws crossing onto D7. The rods had to be contoured in S shape and maneuvered across all screw heads. The patient has remained asymptomatic for more than 2 years after surgery.