Traumatic thoracic spondyloptosis without neurologic deficit, and treatment with in situ fusion
Department of Orthopedics and Physical Rehabilitation
Medical Subject Headings
Adult; Anti-Bacterial Agents; Bone Screws; Device Removal; Humans; Injections, Intravenous; Internal Fixators; Male; Spinal Fusion; Spinal Injuries; Spondylolisthesis; Surgical Wound Infection; Thoracic Vertebrae; Treatment Outcome
Orthopedics | Rehabilitation and Therapy
Thoracic spinal fracture-disassociation (traumatic spondyloptosis) is a rare injury caused by high-energy forces. This injury most often leaves the patient with a severe neurologic deficit. In this article, we report the case of a patient who presented with a complete traumatic thoracic spondyloptosis but no neurologic deficits. He was treated surgically, with posterior instrumented spinal fusion in situ. Given the patient’s spinal canal preservation and overall spinal alignment, reduction was not attempted. The postoperative course was complicated only by a wound infection, at 14 months, when already there was clinical and radiographic evidence of solid fusion. The infection was treated successfully with irrigation and débridement, implant removal, and intravenous (IV) antibiotics. At most recent (30-month) follow-up, the patient was neurologically intact and independently ambulating. Informed consent for publication of this case report and the radiographic images was obtained from the patient.
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Citation: Am J Orthop (Belle Mead NJ). 2009 Oct;38(10):E162-5.