Anterior Reduction And Internal Fixation For Treatment Of No Spinal Injury Lower Cervical Fracture-dislocation Combined With Facet Locking

ObjectiveTo explore the reduction technique, safety and efficacy of anterior reduction andinternal fixation in treatment of lower cervical spine fracture dislocation with facetlocking and no spinal cord injury.Methods21cases of cervical spine fracture dislocation without spinal cord injury combinedfacet locking were treated with anterior reduction and bone graft fusion and platefixation. There were unilateral facet interlocking in7cases, and bilateral locking in14cases. The operation time, intraoperative blood loss, and clinical curative effectevaluated by Odom standard were observed. All patients underwent anteriordecompression with fusion and plate fixation. The preoperative and postoperativeCobb’s angle and the D value of cervical curvature were measured and compare, andthe postoperative osseous fusion rate was calculated as well.ResultsNo spinal cord injury, voice hoarse, esophageal fistula, or neck complications such ashematoma was found in all21cases. Symptoms such as neck pain and restrictedmovement were complete relieved soon after surgery in17cases. Upper limbnumbness were disappeared1weeks postoperatively in4cases, Positive pathologicalreflex was disappeared within1～2weeks in2cases. All patients were followed up for8months to3years (average20.7months). Neural function grade of Frankel wereimproved in varying degrees. Preoperative Cobb’s angle was-4.6±3.87°, whichincreased to6.8±4.09°immediately after surgery and around6.9±4.26°at the end offollow-up. There was statistically significant difference between preoperative andpostoperative (P<0.05), while no significant difference was found between postoperative and follow-up (P>0.05). The D value in preoperative, postoperative andfollow-up were3.2±2.8mm,7.6±3.28mm, and7.8±2.68mm, respectively. There wassignificant difference between pre-and postoperative (P<0.05), while no significantdifference was found between postoperative and follow-up (P>0.05). Duringpostoperative follow-up period, all intervertebral bone graft fusions were completed.ConclusionAnterior reduction with intervertebral bone graft fusion and internal fixation is aneffective method for the treatment of cervical fracture dislocation without spinal cordinjury. This surgery has the advantage of one-stage reduction, avoid complicatedoperation, reduce surgical trauma and risk, and will reduce iatrogenic spinal cordinjury.