Published date: Jul 22 2024

Journal Title: Journal of Spine Practice

Issue title: Journal of Spine Practice (JSP): Volume 3, Issue 2

Pages: 42–51

DOI: 10.18502/jsp.v3i2.14646

L. Erin Miller MD - lmille92@uthsc.edu

Emal Lesha MD - lesha.emal@gmail.com

Jordan T. Roach MS - jordan.roach@stjude.org

Garrett T. Venable MD - venablegarrett@gmail.com

William Mangham MD - wmangham@uthsc.edu

Mallory Dacus MD - mrober41@uthsc.edu

Deke Blum MD - dekeblum@gmail.com

Michael S. Muhlbauer MD - mmuhlbauer@semmes-murphey.com

Raul J. Cardenas MD - rcardenas@semmes-murphey.com

Introduction: Lateral spondyloptosis of the lumbar spine is a rare and devastating form of traumatic spinal injury. Given the paucity of lumbar lateral spondyloptosis case reports in the literature, the authors seek to inform readers of the clinical, radiological, and operative considerations for three patients with this uncommon clinical presentation, as well as provide a comprehensive review of the literature on this topic.

Methods: A retrospective chart review of three patients admitted to Regional One Health Elvis Presley Memorial Trauma Center in Memphis, TN, with traumatic lateral spondyloptosis of the lumbar spine over a three-year period was performed. We also conducted a comprehensive review of the literature on traumatic lateral lumbar spondyloptosis.

Results: Three cases of traumatic lateral lumbar spondyloptosis were identified. Clinical presentation, radiographic findings, and operative considerations are presented.

Conclusions: Traumatic lateral lumbar spondyloptosis is a rare form of translation injury associated with severe neurological deficits. Our experience and thorough literature review broadly advocate for early surgical intervention in these patients. Regardless of whether a neurologic exam is presented, this management strategy may improve neurologic motor outcomes.

[1] Hall OT, McGrath RP, Peterson MD, Chadd EH, DeVivo MJ, Heinemann AW, et al. The Burden of Traumatic Spinal Cord Injury in the United States: Disability-Adjusted Life Years. Arch Phys Med Rehabil. 2019 Jan;100(1):95–100.

[2] Jain NB, Ayers GD, Peterson EN, Harris MB, Morse L, O’Connor KC, et al. Traumatic spinal cord injury in the United States, 1993-2012. JAMA. 2015 Jun;313(22):2236– 43.

[3] Meneghini RM, DeWald CJ. Traumatic posterior spondyloptosis at the lumbosacral junction. A case report. J Bone Joint Surg Am. 2003 Feb;85(2):346–50.

[4] Guttman SL. Spinal Cord Injuries: Comprehensive Management and Research. 2nd ed. Blackwell Science Ltd; 1976.

[5] Hellner H, Nissen R, Vosshulte K. Lehrbuch der Chirurgie. 6th ed. GeorgThieme Verlag; 1970.

[6] Suomalainen O, Pääkkönen M. Fracture dislocation of the lumbar spine without paraplegia. A case report. Acta Orthop Scand. 1984 Aug;55(4):466–8.

[7] Bellew MP, Bartholomew BJ. Dramatic neurological recovery with delayed correction of traumatic lumbar spondyloptosis. Case report and review of the literature. J Neurosurg Spine. 2007 Jun;6(6):606–10.

[8] Yadla S, Lebude B, Tender GC, Sharan AD, Harrop JS, Hilibrand AS, et al. Traumatic spondyloptosis of the thoracolumbar spine. J Neurosurg Spine. 2008 Aug;9(2):145–51.

[9] Cherian I, Dhawan V. Lateral lumbar spondyloptosis. Int J Emerg Med. 2009 Apr;2(1):55–6.

[10] Martin S, Raup G, Hunter S, Cho P. Surgical management of traumatic L2-L3 spondyloptosis. AORN J. 2009 Apr;89(4):657–76.

[11] Wilkinson JS, Riesberry MA, Mann SA, Fourney DR. Traumatic lateral expulsion of the L-4 vertebral body from the spinal column. J Neurosurg Spine. 2011 Apr;14(4):508–12.

[12] Chandrashekhara SH, Kumar A, Gamanagatti S, Kapoor K, Mukund A, Aggarwal D, et al. Unusual traumatic spondyloptosis causing complete transection of spinal cord [SICOT]. Int Orthop. 2011 Nov;35(11):1671–5.

[13] Yadav A, Sharma S. Traumatic Spondyloptosis Causing Complete Transaction of Spinal Cord. Nepal Ortho Assoc J. 2014;3(2):38–40.

[14] Arandi NR, Mundis GM Jr, Kabirian N, Zhang D, Schroerlucke S. Traumatic complete lateral dislocation at the lumbosacral junction: a case report. J Spinal Disord Tech. 2015 Feb;28(1):E56–60.

[15] Mishra A, Agrawal D, Gupta D, Sinha S, Satyarthee GD, Singh PK. Traumatic spondyloptosis: a series of 20 patients. J Neurosurg Spine. 2015 Jun;22(6):647–52.

[16] Garg M, Kumar A, Sawarkar DP, Singh PK, Agarwal D, Kale SS, et al. Traumatic Lateral Spondyloptosis: case Series. World Neurosurg. 2018 May;113:e166–71.

[17] Koruga N. Lumbar Spondyloptosis after Severe Polytrauma: a Case Report. Acta clinica Croatica. 2020;59(3). https://doi.org/10.20471/acc.2020.59.03.23.

[18] Jindong Z, Qing L. Traumatic lateral spondyloptosis of L2 with complete neurological deficit: A case report. Trauma Case Rep. 2020 Jul;29:100339.

[19] Singh R, Prasad RS, Singh A, Singh K, Sahu A. Traumatic Spondyloptosis: Neurological, Surgical, and Outcome Perspectives in a Tertiary Care Center. Indian Journal of Neurosurgery. December 17, 2021. https://doi.org/10.1055/s-0041-1726608.

[20] Barwar N, Netaji J, Munde K. Post-traumatic L4-L5 spondyloptosis with cauda equina syndrome: A case report. Trauma Case Rep. 2021 Apr;33:100475.

[21] Nekhlopochyn OS, Verbov VV, Cheshuk IV, Vorodi MV. Surgical management of traumatic irreducible spondyloptosis of thoracolumbar junction. Ukr Neurosurg J. 2021;27(2):56–64.

[22] Cheng L, Qiu C, Liu XY, Sang XG. Treatment strategy on traumatic mid-lumbar spondyloptosis with concomitant multiple injuries: A case report and literature review. Chinese Journal of Traumatology. 2022;16(1). https://doi.org/10.1016/j.cjtee.2022.06.006.

[23] Wang F, Zhu Y. Treatment of complete fracturedislocation of thoracolumbar spine. J Spinal Disord Tech. 2013 Dec;26(8):421–6.

[24] Shapiro S, Abel T, Rodgers RB. Traumatic thoracic spinal fracture dislocation with minimal or no cord injury. Report of four cases and review of the literature. J Neurosurg. 2002 Apr;96(3 Suppl):333–7.

[25] Vaccaro AR, Lehman RA Jr, Hurlbert RJ, Anderson PA, Harris M, Hedlund R, et al. A new classification of thoracolumbar injuries: the importance of injury morphology, the integrity of the posterior ligamentous complex, and neurologic status. Spine. 2005 Oct;30(20):2325–33.

[26] Denis F. The three column spine and its significance in the classification of acute thoracolumbar spinal injuries. Spine. 1983;8(8):817–31.

[27] Vialle R, Charosky S, Rillardon L, Levassor N, Court C. Traumatic dislocation of the lumbosacral junction diagnosis, anatomical classification and surgical strategy. Injury. 2007 Feb;38(2):169–81.

[28] Xing D, Chen Y, Ma JX, Song DH, Wang J, Yang Y, et al. A methodological systematic review of early versus late stabilization of thoracolumbar spine fractures. Eur Spine J. 2013 Oct;22(10):2157–66.

[29] Ruddell JH, DePasse JM, Tang OY, Daniels AH. Timing of Surgery for Thoracolumbar Spine Trauma: Patients With Neurological Injury. Clin Spine Surg. 2021 May;34(4):E229–36.

[30] Wangtaphan W, Oo M, Paholpak P, Wang Z, Sakakibara T, Kasai Y. Traumatic lumbosacral spondyloptosis treated five months after injury occurrence: a case report. Spine. 2012 Oct;37(22):E1410–4.

[31] Anokwute MC, House H, Huh A, Ordaz J, McVeigh L, Stockwell DW. Systematic Review of Traumatic Thoracic Spondyloptosis and Presentation of a Novel Approach for Management With Quad Rod Construct. Oper Neurosurg (Hagerstown). 2022 Oct;23(4):e237–44.

[32] Paulo D, Semonche A, Tyagi R. Novel method for stepwise reduction of traumatic thoracic spondyloptosis. Surg Neurol Int. 2019 Feb;10(1):23.

[33] Gitelman A, Most MJ, Stephen M. Traumatic thoracic spondyloptosis without neurologic deficit, and treatment with in situ fusion. Am J Orthop. 2009 Oct;38(10):E162– 5.