Effects of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation / 中国矫形外科杂志

[Objective]To evaluate the indications,efficacy and safety of posterior total laminectomy decompression and reduction with pedicle screws for lower cervical fracture and dislocation.[Method]From June 2005 to February 2008,41 patients with lower cervical fracture and dislocation received posterior total laminectomy decompression and reduction with pedicle screws.The patients(M=32,F=9)were 22-47 years old,with an average of 33.5 years old.There were 38 fresh and 3 old injuries.[Result]All the patients were operated on successfully without severe complications during perioperative period.Totally 252 (89%) screws were exactly implanted in the cervical pedicle.The everage surgery time was 3.1 h (2.5-4 h).The average blood loss during the operation was 460 ml (250-950 ml). The average time of follow-up was 27.5 months(24-36 months). All patients had satisfiactory reduction and no internal fixator failure.Thirty-two patients who were followed up for more than 24 months had complete fusion. The motor and sensory score (ASIA92) were improved significantly at 2 years follow-up(P

Anterior Decompression Treatment in the Cervical Spine Injuries with Neurologic Deficits / 대한정형외과학회잡지

To evaluate the neurologic and functional improvement of anterior decompression and fusion in patients with cervical spin injury, the clinical records and x-rays of 17 patients who were treated at Gyeong-Sang National University Hospital between January 1989 and December 1993 were analyzed. The results were as follows 1. There were complete injuries of the cord in six cases, incomplete injuries in nine and nerve root injuries in two. All the patients were treated using anterior decompression and autogenous iliac bone graft with cervical plate fixation within 7 days after trauma. 2. The average time lapse from the operation to radiological union was 9.2 weeks(range;7–14 weeks). 3. The prognosis for neurologic recovery mainly depends on the severity of the initial neurologic status. The recoveries of neurologic deficit were complete in four cases, partial in ten and none in three. The motor index improved from 45.6 to 64.6 and the modified Barthel index was 71.2 points at the last follow-up. 4. The clinical results were excellent in nine cases, good in three, fair in two and poor in three. In conclusion, anterior decompression and fusion with bone graft and cervical plate provided early mobilization and rehabilitation, and improved neurological function in a considerable portion of the patient who had neurologic deficits after cervical spine injuries.