Analysis Of Surgery Through Posterior-anterior Approach To Treat Fracture And Dislocation Of Lower Cervical Spine

Object:To report 19 cases of fracture and dislocation of lower cervical spine in our department. Evaluate the prognosis of patients who are treated by surgical methods, Explore the treatment and surgery strategies for fracture and dislocation of lower cervical spine combined with spinal cord injury, deepen the understanding of fracture and dislocation of lower cervical spine.Materials and Methods:To summarize the clinical features of 19 patients with comparatively integrated materials of 25 fracture and dislocation of lower cervical spine combined with Cervical spinal cord injury from October 2006 to October 2008 in our department, using a retrospective study method, Analysis the treatment, surgery strategies and the influence on the prognosis of patients after operation. All patients are diagnosed with fracture and dislocation of lower cervical spine combined with cervical spinal cord injury before operation, and are fit for and require for surgical treatment. All are examined conventionally by positive-side x-rays, multislice CT and MRI. Assess the clinical effect on the Frankel classification standards of spinal cord and improved JOA assessment standards.Results:The patients were followed up from 14 months to 32 months (average22.4 months).Cervical spine X-ray film prompted a review of all patients with cervical spine fracture and dislocation was reset, the cervical vertebrae sequence and physiological curvature were restored. The bones were fused in 6 months. There were no loosing or migration of a screw or plate, or failure of hardware. Neck and cervicobrachial pain had been cured or greatly improved. Cervical spinal cord injury improved to different degrees according to the Frankel classification standards of spinal cord。Only one case in A, and B do not get any improved. Rank-sum test shows the statistically significant P＜0.05. Improved JOA score is (7.68±2.56) on average preoperatively, and(10.89±3.53) on average postoperatively after follow-up. The difference between before and after operation has the statistically significant (paired t-test, P＜0.01).Conclusions:For patients who has fracture and dislocation of lower cervical spine combined with spinal cord injury, one stage combined posterior-anterior procedure is an essential, safe and effective method for decompression of spinal cord and immediately stability of spine and optimizes the environment for maximum spinal cord function recover when radiographs demonstrate the cervical spinal cord is compressed from both anterior and posterior directions.