Low energy chronic traumatic spondylolisthesis of the axis

Objective The aim of this study is to present a unique case of a patient who presented to our Emergency Department with evidence of a chronic traumatic spondylolisthesis of the axis with severe displacement treated with anterior cervical discectomy and fusion (ACDF) of C2-C3 as well as and posterior cervical fusion (PCF) of C1-C3. Methods One patient with an untreated traumatic spondylolisthesis of the axis with Levine type II injury pattern and 1.2 cm of anterior subluxation underwent ACDF C2-C3 and PCF C1-C3. Results The patient recovered well, radiographs demonstrated reduction of the anterior subluxation, and the patient reported a neck disability index (NDI) score of 20 at 6-month follow-up with full neurologic function intact. The patient was then lost to follow-up. Conclusion In this report, we present an alcoholic patient with a history of many falls who presented with a Levine type II traumatic spondylolisthesis of the axis with signs of chronicity seen on magnetic resonance imaging (MRI). We were able to partially reduce the anterior displacement with traction, but needed both anterior and posterior cervical approaches to achieve adequate reduction and stabilization of the injury.