SURGERY FOR LOWER CERVICAL SPINE INJURIES
https://doi.org/10.14531/ss2007.1.13-20
Abstract
Objectives. To analyze the outcomes of anterior stabilization for lower cervical spine injuries.
Material and Methods. Total of 235 patients was operated on for lower cervical spine injuries. Long-term results (6 months to 3 years) were assessed in 68 patients. All of them underwent plan and functional radiography of the cervical spine. MSCT and MRI were performed to the patients with pain syndrome and residual neurologic symptomatology.
Results. Control radiograms demonstrated interbody fusion in all patients. There was a loss of correction on 3° ± 2° in 9 % of cases caused by subsidence of a crown fixator in a cancellous part of the vertebral body after anterior mono-segmental spinal fusion with resection of a damaged part of the vertebral body. In a group of patients with a plate fixator the achieved perioperative correction of a segment kyphosis was preserved including the cases after anterior mono-segmental spinal fusion with resection of a damaged part of the vetebral body.
Conclusion. Anterior spinal fusion with a bone autograft and plate fixation is a method of choice for unstable lower cervical spine injuries. Complete correction of all types of deformations at a damaged spine segment, safe stabilization of achieved correction, and efficient rehabilitation permit to achieve favorable outcomes after surgery.
About the Authors
Viktor Viktorovich Rerikh
Novisibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
Aleksey Dmitrievich Lastevsky
Novisibirsk Research Institute of Traumatology and Orthopaedics
Russian Federation
Russian Federation
References
1. Борода Ю.И., Заблоцкий Н.У., Ковеленов А.Г. Дифференцированный подход к хирургическому лечению осложненных дислокаций шейных позвонков // Повреждения и заболевания шейного отдела позвоночника: Тез. докл. симпозиума с Междунар. участием. М., 2004. С. 85–86.
2. Ветрилэ С.Т., Юндин С.В., Крупаткин А.И. Хирургическое лечение повреждений нижнешейного отдела позвоночника первично-стальными металлоконструкциями // Повреждения и заболевания шейного отдела позвоночника: Тез. докл. симпозиума с Междунар. участием. М., 2004. С. 94–96.
3. Гринь А.А., Иоффе Ю.С., Казначеев В.М. и др. Тактика обследования и лечения больных при острой травме шейного отдела позвоночника // Повреждения и заболевания шейного отдела позвоночника: Тез. докл. симпозиума с Междунар. участием. М., 2004. С. 87–89.
4. Дуров М.Ф., Осинцев В.М., Юхнова О.М. Оперативное лечение неосложненных повреждений позвоночника // Профилактика травматизма и организация травматологической помощи в нефтяной и газовой промышленности. Диагностика и лечение неосложненных переломов позвоночника. М., 1983. С. 132–135.
5. Заявка № 2005121108 с приоритетом от 05.07.05. Эндофиксатор-пластина для шейного отдела позвоночника / Жеребцов С.В., Рерих В.В. Решение о выдаче патента на изобретение от 16.11.06.
6. Казьмин А.И., Каплан А.В. Актуальные вопросы лечения неосложненных переломов позвоночника // Профилактика травматизма и организация травматологической помощи в нефтяной и газовой промышленности. Диагностика и лечение неосложненных переломов позвоночника. М., 1983. С. 39–47.
7. Лебедев В.И., Быковников Л.Д. Руководство по неотложной нейрохирургии. М., 1987.
8. Alday R., Lobato R. D., Gomel P. Neurosurgery 96, Manual of Neurosurgery / Ed. J. D. Palmer. Edinburgh, 1996. P. 723–730.
9. Argenson C., De Peretti F., Boileau P. Chirurgie des Traumatismes du Rchis Cervical – Techniques Chirurgicales E.M.C. // Orth. Traumat. 1994. Vol. 44. P. 176–191.
10. Argenson C., Lovet J., Sanouiller J.L., et al. Traumatic rotatory displacement of the lower cervical spine // Spine. 1988. Vol. 13. P. 767–773.
11. Argenson C., de Peretti F., Ghabris A., et al. Traumatic rotatory displacement of the lower cervical spine // Bull. Hosp. Jt. Dis. 2000. Vol. 59. P. 52–60.
12. Beyer C.A., Cabanela M.E., Berquist T.H. Unilateral facet dislocations and fracture-dislocations of the cervical spine // J. Bone Joint Surg. Br. 1991. Vol. 73. P. 977–981.
13. Bucci M.N., Dauser R.C., Maynard F.A., et al. Management of post-traumatic cervical spine instability: operative fusion versus halo vest immobilization. Analysis of 49 cases // J. Trauma. 1988. Vol. 28. P. 1001–1006.
14. Cheshire D.J. The stability of the cervical spine following the conservative treatment of fractures and fracture-dislocations // Paraplegia. 1969. Vol. 7. P. 193–203.
15. Connolly P.J., Esses S.I., Kostuik J.P. Anterior cervical fusion: outcome analysis of patient fusied with and withount anterior cervical plates // J. Spinal Disord. 1996. Vol. 9. P. 202–206.
16. Das K., Couldwell W.T., Sava G., et al.Use of cylindrical titanium mesh and locking plates in anterior cervical fusion. Technical note // J. Neurosurg. 2001. Vol. 94. P. 563–569.
17. Doran S.E., Papadopoulos S.M., Ducker T.B., et al. Magnetic resonance imaging documentation of coexistent traumatic locked facets of the cervical spine and disc herniation // J. Neurosurg. 1993. Vol. 79. P. 341–345.
18. Forsyth H.F. Extension injuries of the cervical spine // J. Bone Joint Surg. Am. 1964. Vol. 46. P. 1792–1797.
19. Hall A.J., Wagle V.G., Raycroft J., et al. Magnetic resonance imaging in cervical spine trauma // J. Trauma. 1993. Vol. 34. P. 21–26.
20. Louis R. Traumatismes du rachis cervical.1. Entorses et hernies discales // Nouv. Presse. Med. 1979. Vol. 8. P. 1843–1849.
21. Mahale Y.J, Silver J.R., Henderson N.J. Neurological complications of the reduction of cervical spine dislocations // J. Bone Joint Surg. Br. 1993. Vol. 75. P. 403–409.
22. Roaf R. A study of the mechanics of spinal injuries // J Bone Joint Surg. Br. 1960. Vol. 42. P. 810–823.
23. Roy-Camille R., et coll. Rachis cervical traumatique non neurologique. 1eres Journees de la Pitie. Paris, 1979.
24. Schneeberger A.G., Boos N., Schwarzenbach O., et al. Anterior cervical interbody fusion with plate fixation for chronic spondylotic radiculopathy: a 2- to 8-year follow up // J. Spinal Disord. 1999. Vol. 12. P. 215–220.
25. Schneider R.C. Chronic neurological sequelae of acute trauma to the spine and spinal cord. Part V. The syndrome of acute central cervical spinal-cord injury followed by chronic anterior cervical-cord injury (or compression) syndrome // J. Bone Joint Surg. Am. 1960. Vol. 42. P. 253–260.
26. Segal L.S., Grimm J.O., Stauffer E.S. Non-union of fractures of the atlas // J. Bone Joint Surg. Am. 1987. Vol. 69. P. 1423–1434.
27. Shapiro S.A. Management of unilateral locked facet of the cervical spine // Neurosurgery. 1993. Vol. 33. P. 832–837.
28. Torg J.S., Pavlov H., O’Neill M.J., et al. The axial load teardrop fracture. A biomechanical, clinical and roentgenographic analysis // Am. J. Sports Med. 1991. Vol. 19. P. 355–364.
29. Vernon H., Mior S. The Neck Disability Index: a study of reliability and validity // J. of Manipulative and Physiologic Therapeutics. 1991. Vol. 14. P. 409–415.
30. White A.A., Southwick W.O., Panjabi M.M. Clinical instability in the lower cervical spine. A review of past and current concepts // Spine. 1976. Vol. 1. P. 15–27.
Review
For citations:
Rerikh V.V., Lastevsky A.D. SURGERY FOR LOWER CERVICAL SPINE INJURIES. Russian Journal of Spine Surgery (Khirurgiya Pozvonochnika). 2007;(1):013-020. (In Russ.) https://doi.org/10.14531/ss2007.1.13-20
Email this article 