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Minimally Invasive In-situ Fixation for Complete Traumatic D7-8 Spondyloptosis with Intact Neurology.
Sivashanmugam Dhandapani1, Archit Latawa1
1Department of Neurosurgery, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India.
World Neurosurgery
|October 9, 2024
Summary
Complete traumatic dorsal spondyloptosis, a rare thoracic spine injury, was successfully treated with minimally invasive surgery. This case demonstrates the feasibility of percutaneous pedicle screw fixation for severe spinal dislocations without neurological deficits.
Area of Science:
- Orthopedics
- Neurosurgery
- Spinal Surgery
Background:
- Complete traumatic dorsal spondyloptosis is exceptionally rare in the thoracic spine due to its inherent stability.
- Only two prior cases of this severe spinal injury have been documented in medical literature.
Purpose of the Study:
- To report a rare case of complete traumatic dorsal spondyloptosis at D7-D8 with no neurological involvement.
- To describe the first reported minimally invasive surgical (MIS) approach using percutaneous pedicle screw fixation for this condition.
Main Methods:
- A 31-year-old male with a grade 5 D7-D8 dislocation after a fall underwent in-situ fixation without reduction due to high surgical risks.
- Minimally invasive surgery involved O-arm navigation for percutaneous pedicle screw placement in D5, D6, D8, D9, and D10, with complex rod contouring and placement.
Main Results:
- The patient remained asymptomatic for over two years post-surgery.
- The minimally invasive technique successfully stabilized the severe spinal dislocation without neurological compromise.
Conclusions:
- Minimally invasive percutaneous pedicle screw fixation is a viable and effective treatment option for complete traumatic dorsal spondyloptosis, even in complex, unreduced cases.
- This approach offers a less invasive alternative for managing rare and severe thoracic spine injuries, achieving good long-term outcomes.
