Initial Clinical Observation Of Distractive Flexion Lower Cervical Spine Injury Treatment By Anterior Approach And Closed Traction Reduction Under The General Anaesthesia

With the development of society and the acceleration of industrialization, lower cervical spine fracture happened more and more frequently in clinic. It is reported that about 63 percent of the spinal injury was concerned with cervical spine injury which became the major factor of traumatic death and disability .Our goals of treatment is to recover the alinement of cervical spine, decompress it thoroughly, repair the physio- curvature, re-establish cervical spinal instant stability, relief the mechanical pressure for spinal cord and nerve.Objective: To analyze and compare the effect of tachy-tractate closed reduction after lower cervical spine fracture dislocation under the general anaesthesia and the impact to modus operandi and effectiveness by summarizing the experiences and methods of traditional reestablishment to lower cervical spine fracture dislocation, which can simplify the therapia process and elevate the therapia level.Clinic materials and methods: We collected four cases of the lower cervical spine fracture dislocation who received the C-traction reduction under the general anaesthesia during December 2005 to May 2007. one cases of male, and three cases of female, whose ages from 31 to 53, with the average 43.3. They received the operation 6 to 72 hours after they were in hospital. The position of spine fracture dislocation were: one case of C_4-5,three cases of C_5-6. The Allen typing were: one case of I degree, two cases of II degree,one case of IV degree .Nerve injury Frankel typing were: one case of A degree, one case of C degree, one cases of D degree, one case of E degree. All the patients were received the examination of X-Ray and MRI. One case of lower cervical spine fracture with none dislocation, one case of diplodislocation. one case of lower cervical spine fracture with Unilateral dislocation. All the patients were received the examination of MRI, one case of spinal cord transaction, three cases of spinal cord Edema and hematoma.All the four patients were received the closed tractate reduction under the general anaesthesia, For patients who remain Touce, trachea to the left, arrived in the hands of thumb dislocation of vertebrae before the margin back below the force, while at the back and neck dislocation of cervical vertebrae under the spinous process at the hands of the remaining four Front-end to. Or hear the sound of bombs have consciously bouncing reduction flu, touch-level changes in the neck disappeared, suggesting that the successful reduction. If the unilateral facet locked, the change will be sustained in the head to the side of locking Cequ slow rotation and 30° 45°, reset often hear the beep. Ruoyu have resistance, the immediate cessation of rotation, it could lead to joint fracture and nerve injury . we observed the changes of cortical potential delitescence and wave amplitude by monitoring the cortical somatosensory evoked potential. The delitescence and wave amplitude were improved in two cases. The delitescence and wave amplitude were improved in two cases. Perspective see the successful reduction of the four patients underwent anterior cervical disc between the vertebrae, or total removal, bone grafting, the former plate fixed.Result: Four cases were succeed in the five cases which received the hypo-skull traction reduction, the achievement ratio is 100 percent .All the patients bone grafts were confertus 3 to 12 months after operation .No aversion, collapse of internal fixation happened. The psychiatric symptom of all patients were improved. Frankel typing increased by 1.2 degree.Conclusion: We discovered the tachy-tractate closed reduction under the general anaesthesia has the benefit, short reposition time, high achievement ratio, low spinal medulla injury rate, no complaints compared with traditional reposition, which played an important role for the treatment of dislocation of lower cervical vertebra. The treatment for lower cervical spine distractive flexion fracture dislocation by anterior approach after tachy-tractate closed reduction under the general anaesthesia, which simplify the operation. The anterior approach has the advantage of less hemorrhage, no injury to soft tissue. Therefore, we can easily see that success, under general anesthesia closed traction reset for the lower cervical injury in a very important significance .