Recovery of Neurologic Deficit due to Adequate Initial Treatment of Traumatic Lumbar Spondyloptosis

ABSTRACT

Traumatic spondyloptosis is a rare trauma entity and clinically challenging. Mostly, traumatic spondyloptosis combines severe neurologic deficit and is hard to expect good clinical outcome. It is also named grade 5 spondylolisthesis and reduction of dislocated vertebral bodies is not easy. Initial reduction at the emergency room can cause secondary neurologic injury, therefore, a careful and gentle approach is required. A 54-year-old male suffered an accident at a construction site. The heavily reinforced concrete structure hit him from the back side. Initially, motor grade of both legs decreased to grade 2 at the emergency room. Imaging studies showed lumbar spondyloptosis L4 on L5. Surgery was required and reduction was performed in the-operating room under general anesthesia. Complete reduction and posterior fixation was performed and neurologic deficit improved after surgery. The authors report on a rare case of spinal trauma and discuss initial management and surgical solutions.