Efficacy Of Anterior-posterior Operation For The Treatment Of Lower Cervical Fracture-dislocation Combined With Locked-facet

Objective:To discuss the efficacy of anterior-posterior operation for the treatment of lower cervical fracture-dislocation combined with locked-facet.Methods:16patients with lower cervical fracture-dislocation combined with locked-facet were treated by one-stage anterior-posterior operation between January2012and June2013. All the16patients were taken X-ray plain films after operation, the height of intervertebral space and the cervical Cobb angle were evaluated, and the intervertebral fusion were estimated.As well as, neurological function was evaluated by JOA (Japanese Orthopaedic Association) score and ASIA (American Spinal Injury Association) grade.Results:Incisions of the16patients healed by first intention. All patients were followed up with a mean time of12months (6-24m). One case of trachyphonia due to the recurrent laryngeal nerve injury during operation, treated by neurotrophic medicine and gradually recovered after half a year. Two cases of throat pain were cured after symptomatic treatments. No fixation loosening, breakage, or subsidence occurred.The height of intervertebral space and cervical Cobb angle were significantly improved after operation(P<0.05). The intervertebral fusion rate (Lenke standard),9cases (56.2%) reached A-level,6cases (37.5%) reached B-level,1case (6.3%) reached C-level, and no patient reached D-level.13patients with neurological defect got improvement at different degrees postoperatively, except3patients which preoperative ASIA scale were A or B. The JOA score was significantly increased from (7.6±3.2) preoperation to (13.8±3.6) after3months(P <0.05).Conclusion:Anterior-posterior operation is helpful to decompress spinal cord, rebuild the cervical vertebrae’s sequence and stability. This operation method is safe and effective for patients with lower cervical fracture-dislocation combined with locked-facet.