Abstract:Objective To investigate surgical approaches and their effects in treating fracture and dislocation of the lower cervical spine. Methods A retrospective study was performed on data of 68 patients with fracture and dislocation of the lower cervical spine admitted to our hospital in recent years. All patients received CT, MRI and X-ray examination before and after admission. Among them, 54 patients were treated with anterior surgical approach,10 with posterior surgical approach and four with combined anterior and posterior surgical approach. Neurologic function recovery, dislocation correction, vertebral height restoration and fusion of bone graft were detected postoperatively so as to evaluate surgical outcome. Results None of the patients had aggravation of the neurologic function in follow-up for 6-36 months (average 21 months). All the patients had 1-2 level improvement according to American Spinal Injury Association (ASIA) classification, except for five patients with ASIA grade A injury. Restorations of dislocation and vertebral height were obtained in all patients. Interbody fusion was achieved in average 12 weeks. Postoperative X-ray films showed satisfactory fixation without loosening or fall of screws, and loosening or protrusion of bone grafts. Conclusions Determination of surgical approaches should be based on the fracture types and dislocation of the lower cervical spine, as well as sites and degree of spinal cord compression. In comparison with posterior surgical approach or combined anterior and posterior surgical approach, the anterior surgical approach has advantages of wider indications, shorter operation time and less bleeding, and can more effectively facilitate neural decompression, cervical physiological curvature recovery, cervical spine stabilization and early rehabilitation exercise. Therefore, anterior surgical approach should be the optimal choice in treatment of fracture and dislocation of the lower cervical spine.
CHEN Fei,PU Chun-ming,CAO Ru-rong et al. Surgical approaches and their outcome in treatment of fracture and dislocation of the lower cervical spine[J]. CHINESE JOURNAL OF TRAUMA, 2013, 29(4): 311-315.
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