Methods and therapeutic effects in surgical treatment for lower cervical spine fracture and dislocation
10.3760/cma.j.issn.1001-8050.2015.03.013
- VernacularTitle:下颈椎骨折脱位术式选择及疗效分析
- Author:
Yan GUO
;
Fang ZHOU
;
Yun TIAN
;
Hongquan JI
;
Zhishan ZHANG
- Publication Type:Journal Article
- Keywords:
Spinal fractures;
Cervical vertebrae;
Dislocations
- From:
Chinese Journal of Trauma
2015;31(3):232-235
- CountryChina
- Language:Chinese
-
Abstract:
Objective To discuss the selections of surgical treatment for lower cervical spine fracture and dislocation and the treatment outcome.Methods Clinical data of 50 cases of lower cervical spine fracture and dislocation were analyzed retrospectively.There were 37 males and 13 females at mean age of 41 years (range,20-80 years).Forty-four cases underwent anterior fusion,but 4 with ankylosing spondylitis and 2 with extremely unstable cervical spine were treated with combined posterior fusion.Two cases sustaining ankylosing spondylitis and being unable to be operated via the anterior approach due to the maximum neck flexion limits were treated with posterior decompression and fusion.Two cases developed delayed fracture and underwent posterior release prior to the anterior fixation and fusion.Two cases underwent a second surgery with the posterior release,anterior fusion and posterior fusion performed successively.Neurological performance was evaluated using the American Spinal Injury Association (ASIA)scale.Results All the patients were followed up for mean 28 months (range,12-48 months).Implant loosening and redislocation occurred in one ankylosing spondylitis case 2 months after anterior fusion.Other 49 cases achieved bony fusion in 6 months.Neurological function showed no recovery in complete spinal cord injury cases,but improved for average ASIA 1-2 grades for incomplete spinal cord injury cases.Conclusions Anterior surgery provides good reduction and neurological improvement in treatment of lower cervical spine fracture and dislocation.For extremely unstable cases or difficult anterior reduction cases,posterior surgery or combined anterior/posterior surgery should be considered.
