POSTERIOR APPROACH IN TRAUMATIC THORACIC AND THORACOLUMBAR SPONDYLOPTOSIS

Abstract

Objective: Traumatic spondyloptosis a 100 % or more subluxation of a vertebral unitover another inferior unit in the sagittal or coronal plane is a very rare pathology. Inthis study, clinical findings and follow-up results of 12 patients with spondyloptosisthat occurred after a high-energy trauma were evaluated.Material and Methods: Twelve cases with the thoracic and thoracolumbar regiontraumatic spondyloptosis at two separate centres in the city of Gaziantep between2010 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 causesof 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 andTh4-5); 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 allcases, 5 levels of fixation were performed after reduction with posterior intervention.In addition, 2 patients died; specifically, one patient with thoracic trauma and one withembolism due to deep vein thrombosis at the third month post-op. Severe fusion wasobserved in 9 of our living patients and 1 had a moderate fusion.Conclusion: Acute thoracolumbar spondyloptosis can only be achieved via a posteriorapproach. The intense intercostal area can be used for a fusion bed.