African Health Sciences
Makerere University Medical School
Vol. 18, No. 2, 2018, pp. 458-467
Bioline Code: hs18056
Full paper language: English
Document type: Case Report
Document available free of charge
African Health Sciences, Vol. 18, No. 2, 2018, pp. 458-467
© Copyright 2018 - Ibebuike et al.
Management challenges of traumatic spondylolisthesis of the Axis with an unusual C2-C3 posterior subluxation in a paediatric patient: case report and literature review|
Ibebuike, Kaunda; Roussot, Mark; Watt, James & Dunn, Robert
Introduction: Paediatric cervical spine injuries are uncommon. Traumatic spondylolisthesis of the axis (TSA) is commonly encountered in the trauma setting. The management of TSA may be surgical or non-surgical. Decision making is quite challenging
depending on patient presentation and nature of injury, and even more so in the paediatric age group.
Objectives: To present a case report highlighting the challenges in the management of TSA.
Methods: We present an 8 year old male, who sustained a bilateral C2 pars fracture with associated unusual C2-C3 posterior
Results: Neuroradiological studies identified the fracture/subluxation of C2-C3 and revealed an intact but posteriorly displaced
C2-C3 disc causing cord compression. An Extension Halter traction was initially commenced. This seemed to have worsened
the patient’s neck pains, and caused motor weakness and autonomic dysfunction. An anterior cervical discectomy and fusion
was finally decided on and performed after evaluation and brainstorming by our spinal Unit. Intra-operative findings revealed
separation of the C2-C3 disc from the C3 superior end plate which probably explains the unusual nature of the subluxation.
Conclusion: The case shows that surgical intervention as a primary management for TSA even in the paediatric age group is
safe and also avoids risks inherent in conservative management.
Management challenges; traumatic spondylolisthesis of the axis; C2-C3 subluxation; paediatric; anterior cervical discectomy and fusion (ACDF)