Anterior approach surgery for lower cervical spine dislocation combined with spinal cord injury / 中华创伤杂志

ABSTRACT

Objective:To explore the curative effect of anterior cervical surgery for lower cervical dislocation combined with spinal cord injury.Methods:A retrospective case series study was carried out to analyze the clinical data of 72 patients with lower cervical dislocation and spinal cord injury admitted in Beijing Boai Hospital, China Rehabilitation Research Center from January 2011 to August 2018, including 55 males and 17 females, with an average age of 35.8 years (range, 18-63 years). The segments of injury were at C 3 in 2 patients, at C 4 in 16, at C 6 in 24 and at C 7 in 30. Bases on American Spinal Injury Association (ASIA) grade, there included grade A in 43 patients, grade B in 22, grade C in 6 and grade D in 1. All patients were treated with anterior decompression and fusion. Operation time, intraoperative hemorrhage, decompression and fusion, complications and ASIA grade were observed. Results:All patients were followed up for 3-72 months (average 24.2 months). Operation time was 90-180 months [(118±58)minutes] and intraoperative bleeding volume was 50-180 ml [(104±30)ml]. Spinal cord was decompressed in all patients. The reduction was excellent in 58 patients (81%) and fair in 14 patients (19%). Fusion was confirmed in 48 patients (67%). The complications were improved after timely treatment, including cervical edema in 1 patient, laryngeal edema in 1, cerebrospinal fluid leakage in 4 and axial pain in 2. ASIA grade change of spinal cord injury grade A were recovered to grade B in 2 patients, grade A to grade C in 1, grade B to grade C in 1, grade C to grade D in 2 ( P>0.05). Conclusion:For dislocation of lower cervical spine combined with spinal cord injury, anterior surgery can obtain good decompression, reduction and fusion effect, but it has limited help for improvement of neurological function.