Traumatic cervical posterior spondyloptosis: report of a rare case.

Traumatic spinal spondyloptosis is the extreme degree of spondylolisthesis and is not common. Traumatic cervical anterior spondyloptosis has been reported but we could not find reports of posterior traumatic cervical spondyloptosis. We present an 18-year-old female with this type of injury and cervical complete cord syndrome below C5 and explain our treatment approach.

Treatment strategy on traumatic mid-lumbar spondyloptosis with concomitant multiple injuries: A case report and literature review.

Spondyloptosis in the clinic is rarely reported. We herein present a 47-year-old female, who suffered from a crush injury directly by a heavy cylindrical object from the lateral side. She was diagnosed to have traumatic L3 spondyloptosis with multiple traumas. Staged surgical procedures were conducted and a three-year follow-up was obtained. Eventually, normal spinal alignment was restored, and neurological deficits were gradually improved. At three years follow-up, the motor strength scores and function of the sphincters were incompletely improved. Previously published reports on traumatic lumbar spondyloptosis were reviewed and several critical points for management of this severe type of spinal injury were proposed. First, thoracolumbar and lumbosacral junction were mostly predilection sites. Second, numerous patients involving traumatic lumbar spondyloptosis were achieved to American Spinal Injury Association grade A. Third, lumbar spondyloptosis was commonly coupling with cauda equina injury. Finally, the outcomes were still with poorly prognosis and recovery of patients was correlation to spondyloptosis severity. Based on this case report and literatures review, we highlighted that the spinal alignment restoration relying on staged operations and following rehabilitation hereof are both important once facing with multiple traumas. Furthermore, we suggested to perform routine CT angiography during lumbar spondyloptosis to justify whether there are large vessel compression or injury.

Traumatic dorsal spondyloptosis of upper thoracic spine: case report and novel open reduction technique.

Traumatic thoracic spondyloptosis represents a rare but potentially catastrophic spinal injury pattern. We present a unique case of a 37-year-old male who suffered a high-thoracic retroloptosis with resultant complete spinal cord injury following a motor vehicle accident. We describe a novel and effective method of open reduction utilising horizontally oriented temporary rods facilitating controlled, sequential sagittal distraction and unlocking, reversal of anteroposterior shear and restoration of alignment. Using our technique, successful reduction and realignment was achieved.

Lumbar spondyloptosis after severe polytrauma: a case report.

A rare case of thoracolumbar spondyloptosis after a severe polytraumatic event is presented. Spondyloptosis accounts for a minor proportion of all spine trauma cases and is usually accompanied by complete neurological deficit. A 48-year-old man suffered severe polytrauma after having been hit by a truck at the work place. Radiographic scanning revealed multiple traumatic injuries and spondyloptosis at the L1/L2 level in coronal plane. However, despite extensive injuries, ASIA score was estimated as D. The patient underwent urgent multidisciplinary surgery due to severe head injuries. The next surgery was performed to stabilize the thoracolumbar segment and to preserve neurological functions. The surgery included implantation of transpedicular titanium screws via posterior approach. Good postoperative recovery was achieved during early postoperative rehabilitation at our Department, which was estimated as ASIA score D. In conclusion, prompt operative treatment to achieve neural integrity and early rehabilitation should be considered as the gold standard in such complicated injuries. Postoperative recovery largely depends on the quality of rehabilitation, which leads to improvement of patient self-care and normal social and psychological functions. In our case, the good preoperative neurological status of the patient also contributed to better postoperative outcome.

One-stage posterior spinal shortening by L5 partial spondylectomy for spondyloptosis or L5-S1 high-grade spondylolisthesis management.

STUDY DESIGN: A case series of seven consecutive patients with L5-S1 spondyloptosis (SPP) and Meyerding IV spondylolisthesis (HGSPL) treated consecutively by a new surgical technique with partial reduction and fixation after spinal shortening. OBJECTIVE: To report clinical and radiological outcomes of a spinal shortening procedure by a single posterior approach in seven patients with HGSPL and SPP. BACKGROUND DATA: The surgical treatment of L5-S1 SPP and HGSPL remains challenging, and numbers of surgical treatment options have been described with several principles. We reported a new surgical technique achieving partial reduction and fixation of L5-S1 SPP and HGSPL and highlighted its clinical and radiological outcomes. METHODS: Seven patients with Meyerding Grade IV (2), and Grade V (5) were operated consecutively between 2004 and 2011 for HGSPL and SPP. Surgery time, blood loss and complications were collected for all patients. The slip angle or Dubousset lumbo-sacral Angle (Dub-LSA), L5 slip percentage (%slip), pelvic tilt (PT), lumbar lordosis (LL), thoracic kyphosis (TK) and C7-tilt were measured pre and postoperatively. All patients underwent posterior one-stage decompression with sacral dome osteotomy, L5 vertebrectomy with L5-S1 discectomy, and partial reduction and instrumented fusion in a single posterior approach. RESULTS: The mean age and follow-up were, respectively, 20 years and 65 months. The mean preoperative %slip was 115 %, which improved to 63 % postoperatively. The mean preoperative Dub-LSA, PT, LL, TK, and C7-tilt were 37°, 31°, -74°, 30°, and 6°, respectively, which improved to 94°, 25°, -44°, 42° and -0.14° postoperatively. No implant failure or pseudarthrosis were reported at last follow-up. CONCLUSION: This novel and efficient one-stage shortening technique offers the possibility to manage lumbosacral kyphosis and spinal local malalignment in L5-S1 SPP.

[Surgical treatment of high-grade spondylolisthesis]. / Die operative Therapie hochgradiger Spondylolisthesen.

OBJECTIVE: Establishment of a physiological profile of the spine via reduction of the kyphotic slipped vertebra in the transverse and sagittal planes. Achieving solid fusion. Improvement of preoperative pain symptoms and prevention or elimination of neurological deficits. INDICATIONS: High-grade spondylolisthesis (Meyerding grade 3 and 4) as well as spondyloptosis after conservative treatment and corresponding symptoms. Serious neurological deficits, hip-lumbar extensor stiffness, are emergency indications. CONTRAINDICATIONS (CI): Individual risk assessment must be made. Absolute CI are infections with the exception of serious neurological deficits. Multiple abdominal operations or interventions on the large vessels can be a relative contraindication for ventral intervention. SURGICAL TECHNIQUE: For spondylolistheses of grade 3 according to Meyerding, we recommend a one-stage dorso-ventro-dorsal procedure with radicular decompression, correction and fusion in the index segment. From grade 4 according to Meyerding, reduction of the fifth lumbar vertebral body in the index segment L5/S1 is preceded by resection of the sacral dome. In cases of spondyloptosis, a two-stage procedure is often indicated. In this case, a screw-rod system spanning the index segment is implanted in the first step, which is used to distract the index segment for several days. Ventrodorsal reduction is performed in the second step. POSTOPERATIVE MANAGEMENT: Axis-appropriate full mobilization from postoperative day 1. We recommend a light diet until the first defecation. Dorsal suture removal after 12 days if the wound is dry and free of irritation. Lifting and carrying heavy loads and also competitive or contact sports should be avoided for 12 weeks. RESULTS: From January 2000 to December 2020, a total of 43 patients with high-grade spondylolisthesis were treated in our clinic in the manner described. The Numeric Rating Scale (NRS) and the Oswestry Disability Index (ODI) improved significantly during the observation period of 3 months and 1 year. The 1­year radiological data in 28 of the 36 patients showed complete reduction of the slipped vertebra, in 6 grade 1, and in 2 patients grade 2 according to Meyerding. Also, the kyphosis of the index vertebra was significantly corrected from a mean of 15° (0-52°) preoperatively to a lordotic profile of a mean of 4° (0-11°). No complications requiring revision were observed. One patient with preoperative cauda equina syndrome was left with right radicular sensorimotor S1 syndrome.

Surgical management of traumatic spondyloptosis: a case series.

BACKGROUND: Traumatic spondyloptosis is a rare and severe spinal injury characterized by complete anterior translation of one vertebra over another, often resulting in debilitating neurological deficits. CASE PRESENTATION: We present two cases of traumatic spondyloptosis and elaborate on the clinical presentation, management, and follow-up improvement. The first case is a 30-year-old Nepalese man who sustained traumatic spondyloptosis following a blunt force injury to his back while engaged in tree-cutting activities. The patient presented with severe back pain, left lower limb paralysis, and neurological deficits (consistent with American Spinal Injury Association grade C). Radiographic evaluation revealed total anterior dislocation of the L4 vertebral body over L5, accompanied by fractures of the superior endplates of both vertebrae. The second case is a 35-year-old Nepalese female who presented with back pain and lower limb paralysis following a fall from a 300-m cliff, exhibiting tenderness and ecchymosis in the mid-back region. Radiological examination revealed D12 vertebra translation over L1 with fracture, categorized as American Spinal Injury Association grade A. Both cases were surgically managed and stabilized. CONCLUSION: These cases emphasize the importance of a comprehensive approach to trauma management as well as prompt recognition, and early surgical management in optimizing outcomes for patients with traumatic spondyloptosis.

Successful Surgical Intervention and Remarkable Recovery in a Child With Traumatic Spondyloptosis.

More than 100% of the traumatic subluxation of one vertebral body over another in the coronal or sagittal plane is known as traumatic spondyloptosis, which typically results in the contusion of the spinal cord. It is an uncommon yet severe spinal column injury. Here, we present traumatic lumbosacral spondyloptosis at the L5 and S1 levels with complete spinal cord compression with paraplegia and bowel and bladder involvement. The patient underwent posterior spinal fusion (delta fixation) and decompression. The patient improved his motor and sensory deficits at one-month follow-up. By the eighth-month follow-up, the patient had recovered entirely from his motor and sensory deficits and was stable for the entire year.

Traumatic thoracolumbar spondyloptosis of T12-L1 with stable hemodynamics: A case report.

INTRODUCTION AND IMPORTANCE: A fracture-dislocation of the vertebral bone is mostly caused by high-energy trauma. Spondyloptosis is the severest form of spondylolisthesis (>100 %) which affects the sagital or coronal plane from the contiguous vertebral bone. Anterior spondyloptosis is known as fracture-dislocation where the proximal part of the vertebra is located infront of the distal vertebrae. Most cases are associated with spinal cord injury (SCI) and unstable hemodynamics, in this case the vital sign of the patient's tend to be stable. CASE PRESENTATION: A 21-year-old man had multiple traumas after having a traffic injury, pain and numbness were positive during physical examination, especially in both lower limb. A radiography examination shows that the patient had total spinal cord transection and anterior spondyloptosis in T12 until L1 segment. Additional examinations found minimal renal and liver contusion including the ischemic bowel. The interbody fusion procedure was chosen as our therapeutic modalities. CLINICAL DISCUSSION: We performed open surgical methods by using interbody fusion modalities usually in patient's with stable vital signs. This intervention could be the priority in managing patients with a rare case of anterior spondyloptosis. A visual analog Scale (VAS) was used for monitoring the degree of pain, and Oswestry Disability Index (ODI) questionnaire for evaluating the outcome for low back pain. CONCLUSIONS: Most traumatic spondyloptosis cases end with neurogenic shock, Due to the injury's rarity and collaborated with minimal soft tissue injury, early diagnosis and the use of an open surgical method may improve patient's outcome.

Successful management of delayed traumatic cervical spondyloptosis with neurological deficit: illustrative case.

BACKGROUND: Cervical spondyloptosis is a serious condition scarcely encountered by spine surgeons. Few cases have been reported in the literature. There are no general guidelines for their management, especially in delayed cases. The authors describe their surgical technique for the management of cervical spondyloptosis 45 days after the trauma. OBSERVATIONS: A 28-year-old patient was admitted 45 days after head and cervical trauma leading to quadriplegia with muscular strength at the C5 level. Cervical computed tomography scanning and magnetic resonance imaging revealed C6-7 spondyloptosis with complete slippage of the C6 vertebral body in front of C7. Posterior and anterior cervical spine approaches during the same surgery allowed decompression and stabilization, leading to a dramatic improvement in the neurological deficit. The patient was able to walk 18 months later with near normal balance. LESSONS: Traumatic cervical spondyloptosis requires early management to increase the possibility of decompression through anatomical realignment and stabilization. In delayed cases, a combined anterior and posterior cervical spine approach according to our technique allows decompression and stabilization with a good postoperative outcome possible.

Irreducible L5/S1 Spondyloptosis in Over 20 Years After Neglected Trauma Treated with Modified Grob's Technique - Case Report.

Introduction: Spondyloptosis, characterized by complete slippage of the upper vertebral body relative to the lower vertebral body, is an exceedingly rare condition. Typically, it occurs as a result of a high-energy injury and is promptly managed. It is uncommon for a patient to present to a spinal surgery unit several decades after the initial incident. Case Report: In this case report, we describe the case of a 62-year-old man who experienced a lumbosacral injury from a fall twenty years prior to seeking treatment. The patient had multiple comorbidities, including obesity and internal medicine conditions. He presented with severe back pain radiating to the lower extremities, accompanied by significant neurogenic chroma and lower extremity weakness. Imaging studies revealed spondyloptosis at the L5/S1 level, along with bony fusion and spinal canal stenosis at the L3/L4 level. Conclusion: The patient underwent surgical intervention using Grob's direct pediculo-body fixation technique. The postoperative period was uneventful, and over the course of one year of follow-up, the patient experienced a resolution of symptoms and significant improvement in functional capacity.

Small Bowel Obstruction Secondary to Traumatic Incarceration Between Vertebral Fracture: A Case Report in a Tertiary Care Hospital in Central India.

Bowel injury secondary to blunt trauma abdomen is a commonly encountered entity. However, small bowel obstruction secondary to traumatic incarceration of bowel loops between two translated vertebras in a case of road traffic accident is seldom reported. We report a case of small bowel obstruction in a patient who had suffered spondyloptosis at the L1-L2 level after a motor vehicle accident. We also discuss the diagnostic work up and interventions done to manage the patient. The report also reviews pertinent published literature on the incarceration of the bowel associated with vertebral fractures.

Case report: Traumatic lumbosacral spondyloptosis with locked L5 inferior articular process.

Background: Traumatic lumbosacral spondyloptosis is a very rare spinal disease caused by high-energy trauma. We report a case of traumatic lumbosacral spondyloptosis with locked L5 inferior articular process. Case presentation: A 33-year-old man presented with multisite pain for 6 h following waist trauma and was admitted to the hospital. He suffered multiple injuries from severe impact on the waist after driving an out of control forklift truck. Preoperative imaging examinations revealed that the patient was diagnosed with traumatic lumbosacral spondyloptosis and the L5 inferior articular process was locked into the anterior margin of the S1 vertebra. A posterior instrumentation, decompression of the cauda equina, and interbody fusion procedure was performed. The patient received hyperbaric oxygen and rehabilitation treatment 10 days after the surgery. At the 6-month postoperative follow-up, the muscle strength of the lower limbs was improved, the patient had no numbness of both lower limbs, and the urinary retention symptom was significantly improved. The American Spinal Injury Association grade improved from grade C preoperatively to grade D postoperatively. As far as we know, there have been no relevant reports on traumatic lumbosacral spondyloptosis with locked L5 inferior articular process yet. Conclusion: We believe that the hyperflexion and shear forces were the potential causes of this injury. In addition, the preoperative imaging examinations should be evaluated carefully. If the inferior articular process of L5 were locked, we suggest removing the bilateral inferior articular processes first and then perform reduction.

Thecal sac ligation in the setting of thoracic spondyloptosis with complete cord transection.

Background: Traumatic spondyloptosis (TS) with complete spinal cord transection and unrepairable durotomy is particularly rare and can lead to a difficult-to-manage cerebrospinal fluid (CSF) leak. Methods: We performed a systematic review of the literature on TS and discuss the management strategies and outcomes of TS with cord transection and significant dural tear. We also report a novel case of a 26-year-old female who presented with thoracic TS with complete spinal cord transection and unrepairable durotomy with high-flow CSF leak. Results: Of 93 articles that resulted in the search query, 13 described cases of TS with complete cord transection. The approach to dural repair was only described in 8 (n = 20) of the 13 articles. The dura was not repaired in two (20%) of the cases. Ligation of the proximal end of the dural defect was done in 15 (75%) of the cases, all at the same institution. One (5%) case report describes ligation of the distal end; one (5%) case describes the repair of the dura with duraplasty; and another (5%) case describes repair using muscle graft to partially reconstruct the defect. Conclusion: Suture ligation of the thecal sac in the setting of traumatic complete spinal cord transection with significant dural disruption has been described in the international literature and is a safe and successful technique to prevent complications associated with persisting high-flow CSF leakage. To the best of our knowledge, this is the first report of thecal sac ligation of the proximal end of the defect from the United States.

Cervicothoracic dislocation due to congenital and bone-dysplasia-related vertebral malformations.

PURPOSE: To evaluate the approaches to treatment of congenital and bone-dysplasia-related pediatric cervicothoracic dislocations and define the optimal treatment method. METHODS: The publications available in PubMed and Google Scholar data bases were selected following such criteria as the disease in question, pediatric age, the treatment description, and follow-up results. The paper also includes the descriptions of our own six cases of the cervicothoracic dislocations detected in children with different vertebral malformations. RESULTS: Only eight patients meeting the abovementioned selection criteria were found in the publications: three of them had the Klippel-Feil syndrome (KFS), two had one-level vertebral anomaly, one had neurofibromatosis (NF type 1), one had the Larsen syndrome, and one had a variation of VACTERL association. Their treatment was long term, multi stage, and complicated. Among six our own cases, four patients also had KFS, one had a variation of VACTERL association, and one had NF type 1. All the patients suffered from preoperative neurological disorders. Posterior instrumental fixation with posterior vertebral body resection was performed in four cases and one patient underwent a combined surgery. The parents of one of the patients refused the operation, so he was observed while receiving bracing treatment. Since the treatment was long term and complicated by reoperations, the average follow-up period comprised 5 years. CONCLUSION: Congenital cervicothoracic dislocations are an extremely rare pathology that manifests itself in early age and requires an early surgical treatment. Failure to provide the treatment leads to the patient's disability. The surgical tactics for such patients is determined individually, but the published data and our own experience demonstrate that early multi-stage combined treatment has been the best option available so far. The cervicothoracic dislocations due to NF 1 manifest later and have a more favorable forecast.

Partial vertebrectomy with spine shortening for old spondyloptosis at the thoracolumbar spine: a case series study and literature review.

Objective: We aimed to report the surgical outcomes of serial cases and retrospectively analyze the value of partial vertebrectomy and spinal shortening in the reduction of old spondyloptosis at the thoracolumbar spine. Methods: From 2015 to 2021, eight cases of patients who received a spinal intervention of partial vertebrectomy and spinal shortening for thoracolumbar spondyloptosis over 3 weeks post-trauma were retrospectively summarized. Medical records and surgical outcomes were extracted for clinical safety and efficacy evaluation. Results: Acceptable reduction and immediate stabilization were achieved for all eight cases without causing iatrogenic damage to the viscera. The mean operation time was 3.7 h (range, 3.2-4.2 h) with a mean blood loss average of 1,081 ml (range, 900-1,300 ml). Postoperative stay in the spine department was an average of 11.4 days (range, 8-17 days), followed by an early rehab program. The mean visual analog scale (VAS) for low back pain decreased from 8.0 preoperatively to 1.4 at the last follow-up. The average follow-up period was 19.9 months. As for neurological function recovery, six patients with preoperative ASIA-A status remained unchanged throughout the follow-up period and improvement of one ASIA grade was noted in two patients. At the latest follow-up, sound interbody fusion as well as good alignment of the spinal column were confirmed radiologically in seven patients, while one patient encountered slight re-dislocation 3 months after surgery, but eventually achieved spinal fusion. Conclusion: Partial vertebrectomy and spine shortening via a posterior approach showed good efficacy and safety in the management of old spondyloptosis of the thoracolumbar spine, allowing for a one-step good reduction and spinal fusion for early rehabilitation.

Acute Traumatic Spondyloptosis: A Case Report.

Acute traumatic spondyloptosis (ATS) is a rare condition in the orthopedic literature, with few cases reported. We present a case of ATS in a 35-year-old Hispanic male with multilevel injury, without neurological deficits at the time of injury. The patient was treated in a two-stage method consisting of combined anterior and posterior spinal decompression and fusion. At the six-month follow-up, the patient had no motor/sensory deficits, he remained stable during the one-year period. Conclusion: ATS is rarely seen in patients without neurological deficits on presentation. Although surgical intervention presents significant risks of iatrogenic neurologic compromise, surgical fixation is warranted.

Traumatic cervical spine spondyloptosis: A systematic review.

Background: Spondyloptosis is a rare presentation of cervical spine traumatism where listhesis is more than 100%. Traumatic cervical spine spondyloptosis (TCS) is one of the least discussed forms of cervical spine traumatisms because of its rarity and the gravity of patient's condition, limiting good management, and the number of reported cases. Objectives: This study aimed to discuss clinical, radiological, and best management tools of the aforementioned pathology. Materials and Methods: Scopus, ScienceDirect, PubMed, and Google Scholar databases were searched for English articles about traumatic cervical spondyloptosis. Titles, abstracts, or author-specified keywords that contain the words "spondyloptosis" AND "cervical" AND "spine" were identified. There were no time limits. In sum, 542 records were identified, 63 records were screened, and 46 records were included in this review, describing 64 clinical cases of traumatic cervical spondyloptosis. The clinical cases of two patients managed at our department are also presented and included. In the end, 66 cases were included in this study. Demographics, clinics, radiology, management tools, and outcome of the reviewed cases were discussed. This study was conducted in agreement with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement 2009. The American Spinal Injury Association Impairment Scale (AIS) score was used to evaluate the clinical presentations. Results: This review included 66 patients consisting of 46 males (70%) and 20 females (30%), with a mean age of 41 years. The accident was indicated in 62 cases; it was a road traffic accident in 29 cases (46%), a fall in 24 cases (38%), and motor vehicle accident in 15 cases (24%). The lesion was iatrogenic in four patients. Twenty-one patients were received without motor or sensitive deficit and so scored Grade E on AIS, 10 with Grade D, 11 Grade C, four Grade B, and 20 with Grade A. On imaging, spondyloptosis involved the C1-C2 segment in two cases (3%), C2-C3 in three cases (5.5%), C3-C4 in one case (1.5%), C4-C5 in six cases (9%), C5-C6 in nine cases (13%), C6-C7 in 20 cases (30%), and C7-T1 in 26 cases (38%). In all cases, there was either fracture or dislocation in posterior elements. Bilateral pedicles or facet joint fractures were noted in 53% of the 56 patients where the associated lesions were described, but it jumps to 89% when a vertebra is projected in front of another. In two cases, there was no mention of closed reduction via transcranial traction; in 13 cases (20%), it was avoided for a reason (child, patient's refusal,…). In the 51 cases where the traction was clearly applied, 17 cases (33%) were reduced totally; in 13 cases (25%) the reduction was partial; it failed in 19 cases (37%); and in the remaining cases, the result was not clear. Traction weight varied from 4 kg to 27.2 kg, applied from 6 h to 20 days. Where total reduction was achieved, an average weight of 11.9 kg with proximal average time of 6 days was needed, whereas an average of 11.5 kg was needed for partial reduction with proximal average time of 10 days. 62 patients were operated rather in one or two times. Anterior approach was used in 20 patients (32%), a posterior approach in 14 patients (23%), and combined anterior/posterior approaches in 28 patients (45%). In four patients, the outcome was not available; in the remaining 62 cases, an improvement of an initial deficit was noted in 25 patients (40%), conservation of an initial motor force integrity was noted in 19 patients (30%), and nine patients (14.5%) kept the same initial deficit. Few complications were declared: dura tears with cerebrospinal fluid leaks, meningitis, esophageal laceration, and vocal cord paralysis. There was a mortality of 11% (seven cases). Conclusion: Traumatic cervical spine spondyloptosis predominates in the lowest levels of the cervical spine, allowed in all cases by a failure in posterior elements. It is a lesion with the worst clinical presentation. Traumatic cervical spine spondyloptosis is highly instable, imposing urgent reduction followed by surgical stabilization. At the limit of the reviewed cases, outcome is in general good, but mortality is still important.

Spondyloptosis at Subaxial Cervical Spine with Minimal Neurological Compromise and Complete Recovery: A Rare Case Report.

Introduction: Subaxial cervical spine (C3-7) injuries are among the most common and potentially most devastating injuries involving the axial skeleton. The treatment of fracture dislocations of the cervical spine still varies. Early operative treatment has gained increasing acceptance. This case report will discuss a case of subaxial cervical spine fracture dislocation and spondyloptosis with minimal neurological compromise and after reduction and stabilization, complete recovery of neurological functional was achieved. Case Report: A 26-year-old male patient presented to emergency department with history of road traffic accident with injury to his neck having complain of severe neck and shoulder pain and weakness in the right upper limb. On clinical and radiological evaluation, it was diagnosed a case of high-grade anterolisthesis C5 over C6 (spondyloptosis) with neurological compromise. Surgical intervention was done within 48 h with complete neurological recovery. Conclusion: Satisfactory clinical and good long-term outcome can be obtained in fracture dislocation of subaxial cervical spine by anterior approach, discectomy, and anterior cervical plating.

Spontaneous Fusion of L5/S1 Spondylolisthesis in an Elderly Female: A Case Report.

We report a case of a 65-year-old female presenting with an Anterolisthesis grade I, L5-S1. With a history of lower back pain that started two years ago with weak big toe extension. CT scan revealed that There is anterolisthesis grade I, L5-S1. No pars defect was seen, and degenerative changes in the bilateral facet joint L5-S1, with narrow joint space & sclerosis. The patient underwent conservative management to strengthen and stretch her back muscles for three months and had spontaneous fusion develop at an unstable level with relief of symptoms after nonoperative treatment.