TRAUMATIC CERVICAL SPINE SPONDYLOPTOSIS RESULTING IN

COMPLETE SPINAL CORD INJURY: A CASE REPORT

Samuel Willyarto Anugerah1*, Rully Hanafi Dahlan2

1
Neurosurgery Resident, Neurosurgery Department, Faculty of Medicine, Padjadjaran University - Dr.
Hasan Sadikin Hospital, Bandung, West Java, Indonesia
2
Chief of Spine Division, Neurosurgery Department, Faculty of Medicine, Padjadjaran University - Dr. Hasan
Sadikin Hospital, Bandung, West Java, Indonesia

Abstract

Introduction : The most severe type of cervical spine injury is traumatic cervical spine
spondyloptosis (TCS). As a result of spinal cord compression or transection, the majority of
patient suffer from a total or almost complete spinal cord injury. Here we reported a case of
complete spinal cord injury in a 41-year-old man due to spondyloptosis at level C6–7
succesfully managed with anterior approach only after skull traction.

Case presentation : The patient presented with quadriplegia and absent sensation at level C6
and distal to C6 after a falling tree hit his head. The initial American Spinal Injury
Association Impairment Scale was A. Anterolateral cervical x-ray revealed malalignment,
tear drop fracture at C3 vertebrae, avulsion fracture at C6 spinal process, subluxation at C6–7
vertebrae, and spondyloptosis at C6–7 vertebrae. The patient was managed with close
observation, administration of methylprednisolone, cervical traction and tracheostomy.

Discussions : There is no consensus guideline regarding the management of cervical

spondyloptosis that lead to complete SCI. Whether early decompressive surgery improves
outcomes following SCI is still under debate.

Conclusion: Traumatic cervical spondyloptosis is the most severe type of cervical spine
injury and is an extremely rare type of fracture-related dislocation. Despite, being amenable
to reduction with skull traction, the majority of patient suffer from a total or almost complete
spinal cord injury. Thus, a poor prognosis should be expected for the patient.

Keywords: Cervical spondyloptosis, Cervical spinal cord injury, Traumatic spinal cord
injury

Conflict of Interest: The authors declare no conflict of interest.