Acta clinica Croatica, Vol. 59. No. 3., 2020.
Other
https://doi.org/10.20471/acc.2020.59.03.23
Lumbar Spondyloptosis after Severe Polytrauma: a Case Report
Nenad Koruga
orcid.org/0000-0001-7555-1155
; Department of Neurosurgery, Osijek University Hospital Centre, Osijek, Croatia; Department of Neurology and Neurosurgery, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Anamarija Soldo Koruga
; Department of Neurology and Neurosurgery, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Neurology, Osijek University Hospital Centre, Osijek, Croatia
Ivan Hećimović
; Department of Neurosurgery, Osijek University Hospital Centre, Osijek, Croatia; Department of Neurology and Neurosurgery, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Goran Kondža
; Department of Surgery, Osijek University Hospital Centre, Osijek, Croatia; Department of Surgery, Urology, Orthopedics, Physical and Rehabilitation Medicine, Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Žarko Bakran
; Krapinske Toplice Special Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Vedran Zubčić
; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Maxillofacial Surgery, Osijek University Hospital Centre, Osijek, Croatia
Ante Rotim
; Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
Vinicius Trindade Gomes da Silva
; Department of Neurosurgery, Hospital das Clinicas, Faculty of Medicine, University of Sao Paulo, Sao Paulo, Brazil
Abstract
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.
Keywords
Craniotomy; Spondyloptosis; Hemorrhage, subarachnoid; Neurological rehabilitation; Blindness
Hrčak ID:
247650
URI
Publication date:
1.9.2020.
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