IS OPEN REDUCTION AND ANTERIOR STABILIZATION EFFECTIVE AND SAFE FOR CERVICAL FRACTURES AND DISLOCATIONS? SINGLE INSTUTION EXPERIENCE WITH 21 CASES
Journal Title: Journal of Turkish Spinal Surgery - Year 2016, Vol 27, Issue 2
Abstract
Objective: To present our clinical outcomes with open reduction and stabilization method via anterior approach in patients with cervical fracture and dislocation. Methods: This retrospective study was based on data derived from medical files of 21 patients surgically treated in the neurosurgery department of our institution between 2011 and 2015. Preoperative evaluation was made by means of American Spinal Injury Association (ASIA) and Subaxial Cervical Spine Injury Classification (SLIC) scores as well as radiological data obtained from computerized tomography (CT) and magnetic resonance (MR). Stabilization via anterior approach in supine position was performed routinely within 24 hours after admission. Postoperative controls carried out on 1st, 3rd and 6th months consisted of ASIA impairment scales and Bridwell grades extracted from radiological data. Results: Vast majority of the fractures and dislocations were encountered at the levels of C5-6 (9/21; 42.8%) and C6-7 (8/21; 38.1%). Cervical spines were involved bilaterally in 12 (57.1%) patients. Mortality occurred in 3 cases (14.3%) due to acute respiratory distress syndrome and multiple organ failure within 1 month postoperatively. ASIA impairment scales on 1st and 6th months revealed a gradual recovery, while no difference was observed in terms of Bridwell grades on 3rd and 6th months. Majority of our cases (18/21; 85.7%) were devoid of any remarkable neurological deficits and they were discharged without any complications within 1 week postoperatively. Conclusion: Our results indicate that open reduction and stabilization via anterior approach may be safe and effective operative technique in the management of cervical fractures and dislocations.
Authors and Affiliations
Ahmet Gurhan GURCAY, Oktay GURCAN
Keywords
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