Traumatic spondylolisthesis of the axis

Area of Science:

• Orthopedics
• Neurosurgery
• Trauma Surgery

Background:

• Traumatic spondylolisthesis of the axis (C2 vertebra) is a severe injury.
• Often results from hyperextension and axial loading, frequently associated with facial/scalp trauma and upper cervical fractures.

Purpose of the Study:

• To report on a series of patients with traumatic axis spondylolisthesis.
• To analyze injury patterns, treatment outcomes, and management strategies for this specific spinal injury.

Main Methods:

• Retrospective review of 123 patients with traumatic spondylolisthesis of the axis.
• Analysis of associated injuries, treatment modalities (traction, halo bracing, surgery), and patient outcomes.

Main Results:

• High association with facial/scalp injuries and upper cervical fractures.
• Paradoxically low incidence of neurological injury despite apparent instability.
• Usual union achieved regardless of displacement; traction is safe.
• Halo bracing with early mobilization reduces hospital stay.
• Surgery reserved for chronic instability; anterior C2-3 fusion preferred to maintain atlanto-axial joint rotation.

Conclusions:

• Traumatic axis spondylolisthesis management can be conservative due to inherent stability and low neurological risk.
• Non-operative treatments like traction and halo bracing are effective for most patients.
• Surgical intervention is indicated for persistent instability, with anterior fusion preserving crucial joint function.