Review of management of traumatic spondylolisthesis of the axis in a Tertiary Academic Hospital

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2021

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Orjiako, Livinus Obiora

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Abstract

Background: Traumatic spondylolisthesis of the axis (TSA) is the second most common fracture of the axis after Odontoid fracture. The study aims to review the management of TSA patients who presented at Charlotte Maxeke Johannesburg Academic Hospital (CMJAH). Its objectives will be (i) to describe treatment methods used for TSA (ii) to compare the treatments with international best practices (iii) to determine the mechanism of injuries and types of fracture according to Levine and Edward Classification and (iv) to assess radiological outcomes of treatments. Methods: This was a retrospective study of medical records and radiographs of all patients with TSA who presented to CMJAH from 1st July 2016 to 31st July 2020. All adults 18 years and older with radiological confirmed TSA were included. Patients without follow-up radiological image or lost to follow-up and those with other associated spinal fractures were excluded. We looked at the demographic profile, mechanism of injury, type of fracture, treatment methods and radiological union of the fractures. Results: There were 16 Patients, 75% male and 25% female with average age of 30.5 years were reviewed. There were nine patients (56.2%) with type I fracture, type II, four patients (25%), type IIA three patients (18.8%) and no type III. Motor vehicle accident was the cause in 13 patients (81.2%) and pedestrian vehicle accident in three patients (18.8%). Only two patients with type IIA had operative treatment the rest were treated non-operatively and we had 100% union rate in this study. Conclusion: There was a 100% union rate and this showed that the majority of TSA fractures do very well non-operatively. Furthermore, the management of TSA fractures at CMJAH is in keeping with the current international best practices

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A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, in partial fulfilment of the requirements for the degree of Master of Medicine, 2021

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