Spondyloptosis is the most clinically severe form of spondylolisthesis and is always considered a medical emergency. Virtually all cases of complete vertebral slippage are caused by extreme trauma, although in rare circumstances, degenerative listhesis conditions can progress to this dramatic level if left untreated.
Complete vertebral migration is frightening to see on a diagnostic imaging film. The condition looks more like something out of a science fiction movie, but it is indeed very real and represents a terrible diagnosis to receive. However, there are effective treatments for complete spondylolisthesis and in many cases, the patient can be stabilized and rehabilitated with expert care.
This patient guide explores the worst grade of spondylolisthesis, called spondyloptosis. We will define what the diagnosis means, how it affects the spine and how it should be managed during treatment.
Spondyloptosis is defined as extreme spondylolisthesis in which the grade of vertebral migration can be measured at more than 100% displacement from typical positioning within the spinal column. This most severe manifestation of listhesis very dramatic when visualized on medical imaging studies and virtually always results in macroinstability of the vertebral column.
Vertebral slippage exceeding 100% is virtually always the result of trauma to the spine, although in some patients, it is possible that some degree of listhesis might have preexisted to set the ideal stage for such a dramatic consequence. It is rare for degenerative spondylolisthesis to progress to such a significant level, but it is certainly possible.
When the extent of displacement of one or more vertebral bones reaches more than 100%, the affected patient will virtually always have severe consequences to manage, including any or all of the following:
The spine is unlikely to be stable. Focal and macroinstability are likely results of extreme listhesis conditions.
The spinal cord and or spinal nerves may suffer injury. Results range from pain to neurological dysfunction to motor deficits to paralysis to death.
Patients will virtually always require dramatic surgical intervention as an emergency care measure for such extreme listhesis. Typically, large scale spinal fusion will be used to reconstruct the vertebral column, utilizing a variety of surgical hardware implants that will need to remain in place for life in most case profiles.
Even if the condition is resolved without major neurological trauma being suffered, the patient is likely to suffer reduced physical functionality and increased susceptibility to spinal injury for life.
This most extreme from of vertebral slippage often results from terrible traumas, such as motor vehicle collisions, falls from heights, acts of violence and even less consequential injury in patients with a previous history of spinal trauma or spinal surgery.
This high degree of listhesis can become a fatal condition in patients who do not have access to quality medical care and is often ruled as a contributor to the cause of death following traumas where inadequate medical diagnostic care is provided.
Since the spinal neurological tissues are often compromised during such extreme listhesis traumas, patients who receive quality care might still suffer permanent or transient neurological injury that may have dramatic effects on overall health and physical functionality. In these cases, rehabilitation may or may not provide useful in returning some degree of function to the compromised spine.