Delayed surgical treatment of asymptomatic severe traumatic C7–T1 spondylolisthesis: a rare case report from Syria

Annals of Medicine & Surgery, 2024 · DOI: http://dx.doi.org/10.1097/MS9.0000000000001786 · Published: February 5, 2024

Surgery Trauma Research Methodology & Design

Simple Explanation

Spondylolisthesis is when one vertebra slips over another, which can cause spinal instability and nerve compression. This is especially serious in the neck area (cervicothoracic junction). High-grade slips from trauma in this area usually cause severe issues like spinal cord injury and weakness in all four limbs. This case is unusual because the patient had a severe slip but minimal nerve problems. The patient underwent a surgical procedure that involved fixing the spine from both the back and front (360° fixation). After surgery and follow-up, the patient recovered well with no pain or nerve issues.

Study Duration

6 months

Participants

1 white male patient

Evidence Level

Level 4, Case Report

Key Findings

1
The patient had a grade III traumatic C7–T1 spondylolisthesis with cord compression, a fracture in the C7 vertebra, and disc damage, but surprisingly, no motor neurological deficits.
2
The patient underwent a combined anteroposterior surgical approach (360° fixation) to stabilize the spine.
3
Post-surgery, the patient showed good outcomes with no pain, intact neurological function, and maintained spinal alignment and fusion.

Research Summary

This case report describes a rare instance of a 32-year-old male with severe traumatic C7–T1 spondylolisthesis who presented without motor neurological deficits. The patient underwent a two-stage surgical intervention involving posterior and anterior spinal fixation to achieve 360° stabilization. At 6-month follow-up, the patient exhibited a successful outcome, characterized by pain-free status, preserved neurological function, and radiographic evidence of maintained fusion and alignment.

Practical Implications

Surgical Approach

Combined anteroposterior surgical approach (360° fixation) is a valuable technique for addressing complex spinal conditions.

Early Diagnosis

Careful examination of the cervicothoracic junction is essential in acute traumatic injuries to identify hidden lesions, even in the absence of neurological deficits.

Treatment Strategy

Prompt management is crucial to prevent devastating neurological sequelae.

Study Limitations

1
Unavailability of pre- and post-operative CT scans limited comprehensive imaging analysis.
2
Single case report limits generalizability.
3
The best management approach is arguable due to the rarity of such cases.

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