Traumatic Spondylolisthesis of the Axis without Fracture: Case Report and Literature Review

Author(s): Lívio Pereira de Macêdo, MD, João Batista Monte Freire, MD, Arlindo Ugulino Netto, MD, Kauê Franke, MD, Pierre Vansant Oliveira Eugenio, MD, Glaudir Donato Pinto Júnior, MD, Renan Furtado de Almeida Mendes, MD, Saul Cavalcanti de Medeiros Quirino, MD, Juliano Rodrigues Chaves, MD, Deoclides Lima Bezerra Júnior, MD, Geraldo de Sá Carneiro Filho, MSc, Nivaldo S. Almeida, MD, Hildo Rocha Cirne Azevedo-Filho, MSc, PhD, FRCS

Introduction:

Traumatic spondylolisthesis of the axis is a recurrent up-per cervical spine injury. Axis spondylolisthesis is a broader term, related to when one vertebra slips forward on another, which may in-clude fractures of other vertebral elements and even dislocations not associated with fractures.

Case Presentation:

A 26-year-old male pa-tient was admitted with a report of axial load followed by neck pain and fall from standing height. In the neurological examination, he had no motor, sensory or sphincter deficits. A cervical spine computed to-mography scan with three-dimensional reconstruction was performed, showing spondylolisthesis of C2-C3, without associated fracture, with left facet dislocation and axis lower right facet joint locked. The patient was submitted to a surgical management and he was discharged with cervical collar to ambulatorial follow-up, presenting no neurological complaints.

Discussion:

The absence of fracture in cases of traumatic spondylolisthesis between the C2 and C3 vertebrae is something that is still little reported in the literature, considering its rarity. The classification of these pictures is elementary to define the treatment. Considering the scientific records to date, the stratification proposed by AO Spine can fit the case described. However, there are few studies that discuss the conduct in these cases, probably due to its rarity.

Acknowledgements:

We report an atypical case of C2-C3 traumatic spondylolisthesis, without fracture and without neurological impairment. Due to the low occurrence of cases, the scientific discussion regarding the treatment for such cases is scarce, requiring further stud-ies on the subject.