Anterior Plate Fixation of the Racture / 대한정형외과학회잡지

ABSTRACT

Although anterior fusion has several advantages in the management of fracture-dislocations of cervical spine than posterior methods, it has not been used in common. Because, it does not give sufficient stability to prevent the dislodgment of the graft and angular deformity and it requires prolonged rigid external immobilization. In order to promote the stability and to reduce the external support, authors have fixed with plate and screws in anterior spine fusion for various type of fracture-dislocations of cervical spine, and report the results of 29 consecutive cases. Minimum follow-up period was 6 months (Av. 12mos.). Two level fixation after anterior decompression by corpectomy was done in 7 cases. Ambulation was started from the day after operation with aid of orthosis, regardless of the neurological status. Bone union was observed in all, but one expired case, within 2–3 months. There was no failure in fixation and no worsening in neurology. Improvement of neurological status were observed in 17 patient during and follow up periods of treatment, among 23 patient with neurological symptoms on arrival. The observed complications of hoarseness(2 csses), dysphagia(2 cases) and Horner's syndrome(1 case) were improved later, but the patient with pneumonia was expired one month after operation. It is concluded that the procedure is a safe and better alternative for the fracture-dislocations including flexion injury between C2-T1, because it provides good stability, rapid union, short external support and possibility of neural decomprssion.