| Objective: To compare the therapeutic effects of anterior cross-locking plate andposterior cervical lateral mass screw for treating fracture and dislocation of lowercervical spine.Methods: From January2007to June2012,29patients with fracture and dislocationof lower cervical spine were treated with anterior cross-locking plate and posteriorcervical lateral mass screw. Five3rdcervical vertebra injure cases，nine4th cervical vertebra injure cases，six5thcervical vertebra injure cases，third6th cervical vertebra injure cases，one7th cervicalvertebra injure cases and no less than two cervical vertebra injure cases areincluded.Their functional and radiographic outcomes were retrospectively analyzed tocompare the differences in surgical operation time,bleeding volume during surgicaloperation, fracture healing time, neurological improvement(AISA grades),scorescalculated according to JOA of pre-operation and postoperation,the recovery rate ofpostoperation,,restoring lordosis,wound healing and complication were observed.Wedid the statistics analysis by SPSS17.0software. P<0.05has statistic significance.Results: The29cases had complete follow-up records and a mean follow-up of28.5months(range,16to49months).All cases Achieve good restoration and tovarying degrees to get neurological improvement of both groups.1.In the group of anterior cross-locking plate implantation, the meansurgical operation time was102.6minutes(range,76to168minutes), the meanbleeding volume during surgical operation was123.2milliliters(range,60to410milliliters), the mean fracture healing time was12.47weeks(range,9to17weeks), all cases have no plate and screw fracture,to varying degrees to get neurologicalimprovement according to ASIA(Appendix I),cervical spine curvature was well,theJOA scores of pre-operation was7.53±2.71,the JOA scores of postoperation12months was13.03±2.86, one patient has neck pain.In the group of posterior cervicallateral mass screw implantation, the mean surgical operation time was146.7minutes(range,88to196minutes), the mean bleeding volume during surgicaloperation was316.2milliliters(range,120to1000milliliters), the mean fracturehealing time was12.23weeks(range,9to18weeks), all cases have no plate and screwfracture,to varying degrees to get neurological improvement according toASIA(Appendix I),cervical spine curvature was well,the JOA scores ofpre-operation was7.26±2.66,the JOA scores of postoperation12months was12.89±2.35, one patient has neck pain,one patient has Wound infection.There weresignificant differences between the two groups in surgical operation time,bleedingvolume during surgical operation(P<0.05).There were no significant differencesbetween the two groups in neurological improvement,fracture healing time,JOAscores of pre-operation and postoperation,the recovery rate of postoperation,,restoringlordosis(P>0.05).2.In the group of posterior cervical lateral mass screw implantation,1case ofpartial superficial skin infection resulting in delayed healing, by changing a medicalprescription and antibiotics.Both groups having1case getting neck pain,the result isgetting nice through corresponding symptomatic treatment.There was no significantdifferences between two groups in rate of infection and neck pain(P>0.05).Conclusions:1.As to fracture and dislocation of lower cervical spine, preoperative evaluationof injury mechanism, according to radiographic information to make clear the fractureclassification, making a careful choice of surgical approach and internal fixator.2.Applying the correct principles and techniques, anterior cross-locking plateand posterior cervical lateral mass screw can provide good fixation for fracture anddislocation of lower cervical spine, the clinical therapeutic effects of both are similar. |
