Functional outcome following traumatic spondylolisthesis of the axis

We reviewed 36 consecutive patients, 24 males and 12 females, presenting to our institution, a tertiary referral spinal trauma centre, over a 6-year period. The mean age was 46 (range18-82 years) years. We assessed: (a) the mechanism of injury, (b) the mode of treatment, (c) the radiographic classification using the Levine and Edwards system and (d) functional outcome using the cervical spine outcomes questionnaire (CSOQ) by BenDebba. The commonest mechanism of injury was road traffic accidents. There were 14 Type-I, 11 Type-II and 1 Type-IIA fractures. Twenty-seven patients were treated with halo-vest immobilisation and nine were immobilised in a Minerva jacket. All fractures demonstrated radiographic union at a mean of 12 (range 10-16) weeks. There were no neurological complications. Upon review, all patients, whether Type-I or Type-II demonstrated low CSOQ scores approaching their pre-morbid status. However, Type-II fractures scored higher in three functional outcome categories when compared to Type-I fractures.