OBJECTIVETo study the operative methods for fracture and dislocation of lower cervical spine with articular process interlocking.

METHODSFrom Feb. 2002 to Feb. 2008, 57 patients with fracture and dislocation of the lower cervical spine with articular process interlocking were treated by operation involving interior, posterior and combining anterior and posterior approach, of whom there were 45 males and 12 females aged from 18 to 73 years old with average of 39.5 years. There were 35 patients caused by traffic accident, 17 patients by falling injury and 5 patienst by crash injury of heavy object. Injured cervical segment: there were 4 patienst with C3-C4, 13 patients with C4-C5, 32 patientst with C5-C6 and 8 patients with C6-C7. Fracture types of cervical dislocation: there were 32 patients with unilateral articular interlocking and 25 patients with bilateral articular interlocking. According to ASIA criteria the level of nerve injury was grade A in 9 patients,grade B in 17 patients, grade C in 19 patients and grade D in 12 patients. OPERATIVE METHODS: 14 patients were selected by anterior operation, 11 by posterior operation,and 32 by combining anterior and posterior operation.

RESULTSAll patients were followed up for 3 to 26 months averaged 11 months. According to ASIA criteria, all patients improved 1 to 2 grade. Patients with cervical fracture and dislocation recovered completely with normal cervical sequence and cervical curvature. There was no patients with cervical unstability. Bony fusion were found in the patients with anterior interbody fusion at 12 weeks after operation.

CONCLUSIONThe anterior operation was selected when one segment fractures on fresh and dislocation, or the cervical fracture and dislocation were reduction with traction, or the angulation deformity was severe. The posterior operation was selected when the cervical vertebral plate of articular facet fractures and the compression were from posterior, or multi-segment of cervical injured. The combining anterior and posterior operation was selected when the compression of spinal cord was from both side.