• Kaunda Ibebuike, Mark Roussot, James Watt, and Robert Dunn.
• Visiting Spine Fellow, Division of Neurosurgery, Department of Surgery, Imo State University Teaching Hospital, Orlu, Nigeria.
• Afr Health Sci. 2018 Jun 1; 18 (2): 458-467.

IntroductionPaediatric cervical spine injuries are uncommon. Traumatic spondylolisthesis of the axis (TSA) is commonly encountered in the trauma setting. The management of TSA may be surgical or non-surgical. Decision making is quite challenging depending on patient presentation and nature of injury, and even more so in the paediatric age group.ObjectivesTo present a case report highlighting the challenges in the management of TSA.MethodsWe present an 8 year old male, who sustained a bilateral C2 pars fracture with associated unusual C2-C3 posterior subluxation.ResultsNeuroradiological studies identified the fracture/subluxation of C2-C3 and revealed an intact but posteriorly displaced C2-C3 disc causing cord compression. An Extension Halter traction was initially commenced. This seemed to have worsened the patient's neck pains, and caused motor weakness and autonomic dysfunction. An anterior cervical discectomy and fusion was finally decided on and performed after evaluation and brainstorming by our spinal Unit. Intra-operative findings revealed separation of the C2-C3 disc from the C3 superior end plate which probably explains the unusual nature of the subluxation.ConclusionThe case shows that surgical intervention as a primary management for TSA even in the paediatric age group is safe and also avoids risks inherent in conservative management.

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