Clinical characteristics and stage I operation of anterior and posterior approaches for the treatment of cervicothoracic junction (C7T1) fracture-dislocation / 中国骨伤

ABSTRACT

<p><b>OBJECTIVE</b>To summary the characteristics of cervicothoracic junction (C7T1) fracture-dislocation,and explore the surgical treatment of combined anterior-posterior procedure.</p><p><b>METHODS</b>From January 2005 to March 2010,8 cases of cervicothoracic junction (C7T1) fracture-dislocation were treated by stage I operation through anterior and posterior approacheg, supplemented by non-structural bone graft. All patients were male with a mean age of 45.0 years old ranging from 32 to 68 years. Six cases were diagnosed clearly by CT scan but with normal cervical spine X-ray film at admission. According to AO classification, 4 cases were of type B, 4 cases of type C, with unilateral locked articular process in 2 cases, bilateral in 2 cases. Preoperative MRI showed intervertebral disc injury in 6 cases.</p><p><b>RESULTS</b>The average operation time was 246.3 min ranging from 150 to 320 min. The blood loss was with an average of 307.5 ml (150 to 600 ml). One patient got hoarseness but recovered without special treatment 6 months later; No other complications happened. One patient of preoperative Frankel grade A died, the remaining patients were followed up from 12 to 63 months (38.6 months in average). These fracture-dislocations were completely reduction after operation, healed with bony union 12 months later, and no pseudoarthrosis. The function of the spinal cord improved obviously at the final follow-up, 1 patient of preoperative grade A had died,and the spinal cord function of the other one had no significant changes,the 2 cases of grade B recovered to C and D respectively, 1case recovered from grade C to D, and 3 case recovered from D to E.</p><p><b>CONCLUSION</b>Cervicothoracic junction (C7T1) fracture-dislocation is a rare clinical spine trauma, and missed easily. The CT is a necessary complement to these patients highly suspected C7T1 fracture-dislocation but with negative cervical spine X-ray film. The patients diagnosed clearly could receive stage I operation of anterior and posterior approaches, supplemented with non-structural bone graft.</p>