Decompression via posterior-anterior approach and anterior fixation in treatment of fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation

李 鹏(Li Peng，Dept Orthop Surg，Tianjin Med Univ，Gener Hosp，Tianjin 300052)…∥Chin J Orthop.－2011，31(1).－34～38

Decompression via posterior-anterior ap
proach and anterior fixation in treatment of fracture-dislocation of the lower cervical spine with bilateral facet joints dislocation

李 鹏(Li Peng，Dept Orthop Surg，Tianjin Med Univ，Gener Hosp，Tianjin 300052)…∥Chin J Orthop.－2011，31(1).－34～38

ObjectiveTo evaluate surgical strategy of decompression via posterior-anterior approach and anterior fixation in treatment fracture-dislocation of lower cervical spine with bilateral facet joints dislocation.MethodsThis study retrospectively reviewed 37 cases of lower cervical spine fracture with bilateral joints dislocation.There were 21 males and 16 females with an average age of 42 years(19 －58).Distraction-flexion stage 3(DFS 3)were found in 24 cases and DFS 4 in 13 cases.All the cases were diagnosed by X-ray，CT and MRI and confirmed during the surgery.Decompression via posterior-anterior approach and anterior fixation had been adapted as surgical strategy.The NASCIS and IMSOP standard were applied to definite the level of cervical spinal cord injury.The ASIA grading was used for evaluation spinal cord function and recovery rate.X-ray and CT were used to observe reduction and bone fusion.ResultsMean operative time was(4.5:± 0.5)h，and mean amount of blood loss was 360 mL(200 －500 mL).All the incision healed.The two segments fixation was used in 23 cases，3 segments fixation in 13 cases，and 4 segments fixation in 1 case.Mean follow-up period was 32 months(16 －45 months).Postoperative X-ray and CT showed that bone fusion was achieved in all patients within 4 －8 months，without graft displacement，or failure of implants.Spinal cord function did not aggravate，and sensory recovery ranged from 7 to 20 levels(averaged，12.7).The ASIA grade were improved with an average of one grade.ConclusionTo treat fracture-dislocation of lower cervical spine with bilateral facet joints dislocation，posterlor-anterior approach and anterior fixation/fusion was benefit for preservation of cervical spinal cord function and reconstruction biomechanical stability of cervical spine.16 refs，2 figs，2 tabs.

(Authors)