Surgical management of traumatic thoracic spondyloptosis: review of 2 cases

Spondyloptosis due to trauma is a very rare injury typically associated with motor vehicle accidents and typically at the lumbosacral junction. This report describes two patients with T6-7 and T12-L1 spondyloptosis secondary to trauma. The former was a 36-year-old man who was pinned under a 200 kg hay bale, suffering immediate paraplegia and undergoing successful posterior reduction and stabilization via a single stage posterior approach. Two years after his injury he has not developed any new deformity or neurological deterioration. The latter was a 22-year-old miner who was thrown against the ceiling of a coalmine and suffered a hyperflexion injury resulting in an immediate T12 paraplegia. Again successful reduction and stabilization was able to be achieved through pedicle screw instrumentation via a single-stage posterior approach. These two patients are the first reported cases of traumatic thoracic spondyloptosis. This report describes the rationale, likely mechanisms and surgical technique required for operative reduction and stabilization via a single-stage posterior approach.