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KMID : 0388720070140040221
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Journal of Korean Society of Spine Surgery
2007 Volume.14 No. 4 p.221 ~ p.228
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Treatment of Distractive Flexion Injury in Lower Cervical Spine using Anterior Cervical Fusion
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Park Heui-Jeon
Shim Young-Jun
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Abstract
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Study Design: A retrospective study.
Objectives: To evaluate the availability of anterior cervical plating in the treatment of distractive flexion injury of the lower cervical spine and the relationship between the neurologic findings, types of dislocation, and disc herniation.
Summary of Literature Review: Anterior stabilization of unstable cervical spine injuries is increasing. However, the stability of anterior stabilization only is controversial for the treatment of bilateral dislocation of the cervical spine.
Material and Methods: We retrospectively analyzed 32 patients treated with anterior decompression, auto-iliac bone graft, and anterior cervical plating, who suffered from distractive flexion injury in the lower cervical spine from Feb. 1999 to Feb. 2006. Unilateral dislocation occurred in 21 cases, bilateral dislocation in 11 cases, with evaluation of disc status at the injured level conducted after closed reduction by MRI. We statistically analyzed changes in vertebral body height, disc angle, fusion rate, neurologic recovery, and complications.
Results: All cases were fused by 12.3±2.7 weeks after operation, and the loss of anterior and posterior vertebral body height were statistically significant (p=0.00, 0.00), changes in the disc angle were not (p=0.53). Herniation of the disc was more frequent in unilateral dislocation (p=0.02). Clinically 21 (65%) patients had neurologic deficits, but nerve root injuries recovered in all cases, with the original average ASIA motor score of 55.2 improving to 68.3 at last follow up.
Conclusions: Anterior decompression, bone grafting, and metallic osteosynthesis were effective treatment modalities for distractive-flexion injuries of the lower cervical spine, causing slight vertebral body height decreases but no loss of reduction or neurologic compromise.
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KEYWORD
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Cervical spine, Distractive flexion injury, Anterior plating, 경추, 신연-굴곡손상, 전방유합술
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