Circumferential Reconstruction of Subaxial Cervical and Cervicothoracic Backbone by Concurrently Mixed Anterior-posterior Approaches within the Sitting Place.
Orthop Surg. 2017 Aug;9(three):263-270
Authors: Han Y, Ma XL, Hu YC, Miao J, Zhang JD, Bai JQ, Xia Q
OBJECTIVE: To introduce and analyze the feasibility of a brand new surgical technique for circumferential reconstruction of subaxial cervical and cervicothoracic backbone by concurrently mixed anterior-posterior method within the sitting place.
METHODS: A retrospective evaluate was carried out for seven sufferers who underwent the above surgical process between July 2011 and January 2015. Among the many seven sufferers, there have been six males and one lady, with a median age of 52?years (vary, 36-79?years). Six sufferers have been confirmed to have a decrease subaxial cervical fracture and dislocation with a locked side joint, and the opposite affected person had an invasive tumor involving each anterior and posterior elements of vertebrae and lamina, detected by radiological examination. The degrees concerned for all sufferers have been from C4 to T2 . In line with American Spinal Damage Affiliation (ASIA) classification, one case was class A, 4 have been class B, and two have been class D. The sufferers have been restricted within the sitting place with traction and a halo in extension to immobilize the pinnacle in the course of the operation. The concurrently mixed anterior-posterior operation for discount, decompression or tumor resection and circumferential reconstruction was carried out.
RESULTS: Each anterior and posterior procedures have been efficiently accomplished concurrently within the sitting place in all circumstances. There have been no perioperative problems. The common operative time was 175?±?32?min (vary, 120-240?min), and the imply blood loss was 430?±?85?mL (vary, 200-1100?mL). The sufferers have been adopted up for 35.eight?months (vary, 18-60?months). The symptom of neck ache improved distinctly and no proof of implant failure was famous in any sufferers. Neurological standing enchancment was confirmed in six sufferers, who had suffered incomplete paralysis. The ASIA grade improved in 5 sufferers, and two circumstances had no change in grade.
CONCLUSIONS: The “sitting place” concurrently mixed anterior-posterior method is secure and is superior to the normal susceptible place and supine place, and the surgical outcomes are passable.
PMID: 28960819 [PubMed – indexed for MEDLINE]