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

Abstract

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

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

Methods: 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.

Results: 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.

Conclusion: 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.