Modified anterior-only discount and fixation for traumatic cervical aspect dislocation (AO sort C accidents).
Eur Backbone J. 2017 Dec 26;:
Authors: Kanna RM, Shetty AP, Rajasekaran S
PURPOSE: Surgical discount of uni and bi-facetal dislocations of the cervical backbone (AO sort C accidents) could be carried out by posterior, anterior or mixed approaches. Ease of entry, low an infection charges and fewer dangers of neurological worsening has popularized anterior strategy. Nonetheless, the discount of locked cervical sides could be intricate by means of anterior strategy. We analyzed the security, efficacy and outcomes at a minimal 1 yr, of a novel anterior discount approach for consecutively handled cervical aspect dislocations.
MATERIALS AND METHODS: Sufferers with single stage traumatic sub-axial cervical dislocation (n = 39) handled by this modified anterior approach had been studied. The approach concerned normal Smith-Robinson strategy, discectomy past PLL, use of inter-laminar distracter to distract whereas Caspar pins had been used as “joysticks” (both flexion-extension or lateral rotation moments are supplied), to scale back the sub-luxed sides. Amongst 51 sufferers with cervical sort C harm handled in the course of the examine interval, Four sufferers who had spontaneous discount and eight handled by deliberate international fusion had been excluded.
RESULTS: 39 sufferers of imply age 49.9 years had been studied. The degrees of harm included (C3-Four = 2, C4-5 = 5, C5-6 = 20, C6-7 = 12). 18 had been bi-facetal and 21 had been uni-facetal dislocation. One aspect was fractured in 17 and each in 5 sufferers. 30% (n = 13) had a concomitant disc prolapse. The neurological standing was as follows: 9 ASIA A, 9 ASIA C, 13 ASIA D and eight ASIA E. All of the sufferers had been efficiently lowered by this method and glued with anterior locking cervical locking plates. No supplemental posterior surgical procedure was carried out. 22 sufferers with incomplete deficit confirmed restoration. The imply follow-up was 14.three months and there was no implant failure besides one affected person who had partial lack of the discount.
CONCLUSION: Sufferers with traumatic sub-axial cervical dislocation (AO sort C accidents) could be safely and successfully lowered by this method. Different benefits embody minimal blood loss, much less dangers of an infection, shorted fusion zone, good fusion price and neurological restoration.
PMID: 29279998 [PubMed – as supplied by publisher]