Perioperative management and neurological outcomes of traumatic spondyloptosis: A retrospective case series of 14 patients

doi:10.5312/wjo.125014

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World Journal of Orthopedics

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2218-5836

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.

World J Orthop. Oct 18, 2026; 17(10): 125014
Published online Oct 18, 2026. doi: 10.5312/wjo.125014

Perioperative management and neurological outcomes of traumatic spondyloptosis: A retrospective case series of 14 patients

Xing-Sheng Yu, Zhao-Hu Mao, Cheng Qiu, Ling-Zhi Zhang, Zheng-Qi Chang

Xing-Sheng Yu, Zhao-Hu Mao, Zheng-Qi Chang, Department of Orthopaedic Surgery, The 960^th Hospital of the PLA, Jinan 250031, Shandong Province, China

Cheng Qiu, Department of Orthopaedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China

Ling-Zhi Zhang, Department of Ultrasound Diagnosis, The 960^th Hospital of the PLA, Jinan 250031, Shandong Province, China

Co-corresponding authors: Ling-Zhi Zhang and Zheng-Qi Chang.

Author contributions: Yu XS and Mao ZH carried out the study conception; Yu XS, Mao ZH, Qiu C, Zhang LZ and Chang ZQ carried out the literature review and prepared the manuscript draft; Qiu C, and Zhang LZ prepared the figures and tables; Yu XS, and Chang ZQ performed data collection, and analysis; all authors discussed and commented on the final manuscript. All authors read and approved the final manuscript. Zhang LZ and Chang ZQ are appointed as co- corresponding authors given their equally important intellectual contributions to this study. Zhang LZ participated in clinical study design and clinical data interpretation. Chang ZQ supervised the whole project and performed major manuscript revision. Both authors take joint accountability for this manuscript. All authors have consented to this authorship arrangement.

AI contribution statement: No artificial intelligence tools were utilized in the preparation of this manuscript. All contents were fully written, reviewed and validated by the authors.

Institutional review board statement: The study was approved by the Institutional Review Board of the 960^th Hospital of PLA (Ethics approval 2026 No. 039).

Informed consent statement: Written informed consent was obtained from all patients, and this study was approved by the Institutional Review Board of the 960^th Hospital of PLA.

Conflict-of-interest statement: The authors declare that there are no conflicts of interest related to this article.

Data sharing statement: The datasets generated and analyzed during the present study are not publicly available due to patientprivacy restrictions, but are available from the corresponding author upon reasonable request.

Corresponding author: Zheng-Qi Chang, Department of Orthopaedic Surgery, The 960^th Hospital of the PLA, No. 25 Shifan Road, Tianqiao District, Jinan 250031, Shandong Province, China. 26766771@qq.com

Received: June 30, 2026
Revised: August 28, 2026
Accepted: October 13, 2026
Published online: October 18, 2026
Processing time: 110 Days and 20.3 Hours

Abstract

BACKGROUND

Traumatic spondyloptosis is a severe, high-energy spinal injury, and priority should be given to emergency resuscitation and vital-sign stabilization during the perioperative period.

AIM

To analyze the clinical characteristics, perioperative treatment strategies, surgical protocols, and long-term neurological rehabilitation outcomes of patients with traumatic spondyloptosis.

METHODS

A retrospective analysis was conducted on 14 adult patients diagnosed with traumatic spondyloptosis who were admitted to our orthopedic department from January 2018 to January 2025. Clinical data, including demographic characteristics, injury mechanisms, combined fracture sites, spinal injury segments, preoperative resuscitation measures, surgical approaches, postoperative rehabilitation protocols, and neurological function assessed by the American Spinal Injury Association (ASIA) impairment scale, were analyzed. All patients completed at least 12 months of regular follow-up to evaluate surgical efficacy, fracture healing and neurological recovery.

RESULTS

Among the 14 patients, 11 had polytrauma with extra-spinal fractures involving the scapula, ribs, maxilla, skull and other parts, and three presented with hemorrhagic shock on admission and received emergency resuscitation. Thirteen patients underwent posterior-only spinal surgery, and one patient underwent combined anterior-posterior surgery, with complete anatomical vertebral reduction achieved in all cases. Preoperatively, all patients had severe neurological deficits (ASIA A or B). At the final follow-up, eight patients achieved elevated ASIA grades, five showed obvious neurological recovery, three showed mild improvement, and six remained unchanged. Postoperative complications included joint contractures, pneumonia, pressure ulcer, urinary tract infection, and deep vein thrombosis.

CONCLUSION

Posterior surgical treatment combined with individualized postoperative rehabilitation is useful and can achieve complete spinal reduction, relieve spinal cord and nerve root compression, promote fracture healing and improve neurological recovery.

Keywords: Spondyloptosis; Fractures; Clinical management; American Spinal Injury Association; Rehabilitation

Core Tip: Traumatic spondyloptosis is a high-energy injury frequently associated with polytrauma and hemorrhagic shock, demanding prioritized emergency resuscitation. In this 14-patient retrospective series, posterior-only instrumentation (with one combined anterior–posterior case) achieved complete anatomical reduction in all cases. Although all patients presented with severe preoperative neurological deficits American Spinal Injury Association (ASIA) (ASIA A/B), 8 of 14 attained ASIA grade elevation at final follow-up. Individualized postoperative rehabilitation reduced complications and promoted neurological recovery, supporting posterior surgery plus tailored rehabilitation as a useful strategy.