Traumatic Cervical Spondyloptosis: A Comprehensive Analysis of 16 Cases at a Level 1 Trauma Center in a Developing...

Traumatic cervical spondyloptosis (TCS) is a rare and the most severe form of cervical spine injury.

The primary and secondary objectives were assessment of improvement in neurological status and rate of complications respectively.

Sixteen patients of TCS operated between 2015 and 2019 were included. The pertinent details including demographics, neurological status, associated injuries, reduction method, surgical approach, complications, and outcomes at follow-up were recorded.

The mean age was 35.0 ± 12.1 (range 16-65). Fall from height (56%) and road traffic accidents (37.5%) were the common modes of injury. The most common level of injury was C6-C7 in eight patients, C5-C6 in five patients, and C7-T1 in two patients. The neurological status was ASIA A, D, and B in 12, 3, and 1 patients, respectively. Seven patients had one or more associated injuries. Surgical approaches included anterior (A), anterior and posterior (AP), and APA approach in 8, 6, and 2 patients, respectively. Cerebrospinal fluid leak was noticed in six cases. The median postoperative ICU stay was 17.5 days (2-80 days). Ten (62.5%) patients had one or more major postoperative complications. Four patients died during the hospital course. Of the 10/12 discharged patients who followed up, 6 patients (ASIA A) expired within 12 months from complications of recumbency. Three out of the remaining four patients, who survived, showed improvement.

We report the largest case series of TCS to the best of our knowledge. These cases can be a surgical challenge, and complications and outcomes depend on the function of preoperative neurological status of the patient.