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Residual Deformity After Anterior Cervical Discectomy and Fusion for Unstable Hangman’s Fractures.

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Residual Deformity After Anterior Cervical Discectomy and Fusion for Unstable Hangman’s Fractures.

World Neurosurg. 2017 Dec;108:216-224

Authors: Li G, Yang Y, Liu H, Hong Y, Rong X

Summary
BACKGROUND: Anterior cervical discectomy and fusion (ACDF) is a generally used surgical procedure for unstable hangman’s fractures. This research investigated the speed of residual deformity after ACDF for these fractures and the impact of residual deformity on scientific and radiologic outcomes.
METHODS: A retrospective evaluation of 28 sufferers with unstable hangman’s fractures handled with ACDF was undertaken. The angulation and anterior translation between C2-C3 have been measured on lateral radiographs on the time of admission, after cranium traction, within the preliminary postoperative interval, and at remaining follow-up. Residual deformity after surgical procedure was outlined as important angulation (?6°) and/or translation (?three mm). Sufferers have been divided into 2 teams: with and with out residual deformity. Observe-up analysis included scientific and radiologic outcomes.
RESULTS: Imply follow-up time was 22 months. The group with residual deformity included 7 sufferers with an angulation of ?11° and/or translation of ?four mm after cranium traction. The remaining 21 sufferers with out residual deformity had an angulation of <11° and translation of <four mm after cranium traction. Neck ache and neurologic deficits improved considerably in all sufferers after surgical procedure. No important adjustments of alignment of center and decrease cervical vertebrae have been noticed.
CONCLUSIONS: Residual deformity after ACDF for unstable hangman’s fractures will not be uncommon, and it appears to don’t have any important impact on scientific consequence throughout short-term follow-up. A extreme deformity between C2-C3 after cranium traction could also be a predictor of residual deformity.

PMID: 28867313 [PubMed – indexed for MEDLINE]

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