Surgical Treatment of the Unstable Lower Cervical Spine Injuries / 대한정형외과학회잡지

ABSTRACT

Injuries of the cervical spine from C3 down to C7 are complex and potentially devastating injuries. The treatment of this condition is complicated and controversial. However, there is an increasing tendency to stabilize unstsble cervical spine injuries surgically with the benefit of good stability of the spine, easy nursing care, early mobilization and rehabilotation. We analysed clinically the 26 patients with unstable lower cervical spine injuries st the department of orthopaedics, National Medical Center from Jan. 1979 to Dec. 1988. The results obtained were as follows1. The prevalent age distribution was between 20 and 50 years of age(71%), and the ratio between male and female was 6 l. 2. The most common cause of the injury was traffic accident(42%), and the most frequent mechanism of injury was distractive-flexion type(42%). 3. In the overall clinical evaluation, 73% of the patients were judged to have had excellent and good results, and the range of the motion was more limited in the patient who underwent posterior fusion due to wide level of fusion. 4. The patients with distractive-flexion injuries with minimal neurologic deficit were at risk of late instability following conservative treatment, and therefore open reduction and posterior fusion may be advisable. 5. The patients who were given posterior fusion were noted to have a few significant late changes, but the patient with anterior fusion carried a high incidence of progressive kyphotic deformity and persisting, pain. 6. When anterior fusion is used in the patient with posterior instability for the purpose of cord decompression, anterior cervical plate is valuable than the fusion with graft only in view of preventing progressive kyphotic deformity.