Original Article

POSTERIOR APPROACH IN TRAUMATIC THORACIC AND THORACOLUMBAR SPONDYLOPTOSIS

  • Ömer POLAT
  • Mehmet SEÇER
  • Kadir ÇINAR
  • Murat ULUTAŞ
  • Oğuz Durmuş KARAKOYUN

Received Date: 11.09.2018 Accepted Date: 01.01.2019 J Turk Spinal Surg 2019;30(2):139-143

Objective:

Traumatic spondyloptosis a 100 % or more subluxation of a vertebral unit over another inferior unit in the sagittal or coronal plane is a very rare pathology. In this study, clinical findings and follow-up results of 12 patients with spondyloptosis that occurred after a high-energy trauma were evaluated.

Material and Methods:

Twelve cases with the thoracic and thoracolumbar region traumatic spondyloptosis at two separate centres in the city of Gaziantep between 2010 and 2016 were examined retrospectively. The clinical and radiological results, additional system injuries and long-term results of the patients were evaluated.

Results:

The mean age of the patients (9 men and 3 women) was 30.4. The causes of trauma were falling down from a height (8 cases) and a traffic accident (4 cases). Spondyloptosis was detected at the upper thoracic level in two cases (Th3-4 and Th4-5); Th9-10, one case; Th10- 11, four cases; Th11-12, three cases and Th12-L1, two cases. Pre- and postoperative neurological status of all cases was ASIA A. In all cases, 5 levels of fixation were performed after reduction with posterior intervention. In addition, 2 patients died; specifically, one patient with thoracic trauma and one with embolism due to deep vein thrombosis at the third month post-op. Severe fusion was observed in 9 of our living patients and 1 had a moderate fusion.

Conclusion:

Acute thoracolumbar spondyloptosis can only be achieved via a posterior approach. The intense intercostal area can be used for a fusion bed.

Keywords: Spondyloptosis, trauma, surgery, fusion