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;
23:e237-e244. [PMID:
36103319 DOI:
10.1227/ons.0000000000000338]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 05/05/2022] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND
Traumatic thoracic spondyloptosis (TTS) is a rare but devastating spinal injury often secondary to high-impact trauma. TTS is typically managed with surgical fusion and stabilization.
OBJECTIVE
To evaluate current surgical management of TTS while presenting a novel surgical technique for reduction and fusion.
METHODS
We performed a systematic review of surgical management of TTS using Preferred Reporting Items for Systematic Reviews and Meta-Analyses of Individual Participant Data guidelines with 2 independent reviewers. We identified patient demographics, level of spondyloptosis, American Spinal Injury Association grade, level of spinal fusion, surgical approach, type of construct used, and reduction of fracture.
RESULTS
Seventeen articles with 37 patients with TTS managed surgically were identified. The male:female ratio was 31:6. The average age was 33 years (±15). Motorized injury including motor vehicle accident, road traffic accident, and motor vehicle collision (16 patients, 43%) and fall including fall from height, stairs, train, or standing (16 patients, 43%) were equivalent. The middle (15 patients 40%) and lower (18 patients, 49%) thoracic regions were similar for the level of spondyloptosis. Thirty-four patients (92%) were American Spinal Injury Association A. Thirty-six patients (97.3%) underwent posterior only surgery and 1 (2.7%) underwent a combined posterior-anterior approach. There were 29 (78%) dual rod constructs and 8 (22%) dual rod with connectors or crosslinks. Complete reduction was obtained in 24 (65%) patients, incomplete in 11 (30%), and 2 (5%) patients were not reported. Two of our patients underwent novel quad rod reconstruction with complete reduction.
CONCLUSION
Surgical management of TTS is typically posterior only with complete fracture reduction. We have presented a novel quad rod approach for reduction of TTS.
Collapse