Operative treatment of subaxial cervical dislocation without spinal cord injury / 中华创伤杂志

ABSTRACT

Objective To discuss the selection and clinical efficacy of operative methods for subaxial cervical dislocation without spinal cord injury. Methods A retrospective study was performed on 11 patients with subaxial cervical dislocation without spinal cord injury treated from January 2004 to June 2009. According to Allen' s classification, all patients suffered from retracted flexion injuries, including seven patients with Ⅰ degree dislocation, one with Ⅱ degree dislocation and three with Ⅲ degree dislocation. There were eighth patients with old dislocation and three with fresh dislocation, both of which were simple cervical trauma without other organ injuries. Open reduction, internal fixation and iliac bone graft spinal fusion were performed in seven patients and combined posterior and anterior open reduction,internal fixation and iliac bone graft spinal fusion in four. All the patients were followed up for observation of clinical effect. Results All operations were completed successfully. There were 11 patients at Frankel grade E preoperatively and 11 at grade E postoperatively. X-ray photographs showed that the sequence and curvature of the cervical spine recovered to normal after operation. All patients were followed up for 3-31 months postoperatively, which showed no redislocation or symptoms of spinal cord injury.Conclusion For lower cervical dislocation combined with locked facet, one-stage combined anterior and posterior reduction and internal fixation should be performed. While for those without locked facet, simple anterior reduction and bone graft spinal fusion is needed. Open reduction, internal fixation and bone graft spinal fusion are effective method for treatment of subaxial cervical dislocation without spinal cord injury.